FM 3-19 Physical Security

FM 4-20.
65 (FM 10-286)
Identification of Deceased Personnel
July 2005
DISTRIBUTION RESTRICTION: Distribution authorized to DOD components (DOD contractors

only on a case-by-case basis) in accordance with the foreign disclosure authority, TRADOC Reg.
350-70. This determination was made on 12 April 2005. Contractor and other requests for this
document must be referred to Commander, ATTN: ATSM-MA, U.S. Army Quartermaster Center
and School, Fort Lee, VA 23801-1601.
DESTRUCTION NOTICE: Destroy by any method that must prevent disclosure of contents or
reconstruction of the document.
Headquarters Department of the Army

This publication is available at Army Knowledge
Online (www.us.army.mil) and the General Dennis J. Reimer
Training and Doctrine Digital Library at
(www.train.army.mil).
*FM 4-20.65 (FM 10-286)
Field Manual Headquarters

No. FM 4-20.64 (10-286) Department of the Army
Washington, DC, 27 July 2005
Identification of Deceased Personnel
Contents
Page
PREFACE .............................................................................................................ix
ACKNOWLEGEMENTS ........................................................................................x
Chapter 1 THE IDENTIFICATION PROCESS AND MORTUARY PROTOCOLS............. 1-1
Background ........................................................................................................ 1-1
Responsibilities................................................................................................... 1-1
Policies for the Forensic Identification of Remains ............................................ 1-1
Records .............................................................................................................. 1-2
Examinating and Recording Data....................................................................... 1-2
Identifying Media ................................................................................................ 1-3
Processing Remains .......................................................................................... 1-3
Chapter 2 BASIC GROSS HUMAN ANATOMY ................................................................ 2-1
Objective............................................................................................................. 2-1
Glossary of Anatomical Terminology.................................................................. 2-1
Major Internal Organs......................................................................................... 2-4
Chapter 3 ANTEMORTEM AND PERIMORTEM TRAUMA............................................... 3-1
Objective............................................................................................................. 3-1
Wounds and Injuries........................................................................................... 3-1
Asphyxia ........................................................................................................... 3-21
Drowning .......................................................................................................... 3-22
DISTRIBUTION RESTRICTION: Distribution authorized to DOD components (DOD contractors only

on a case-by-case basis in accordance with the foreign disclosure authority, TRADOC Reg. 350-70.
This determination was made on 12 April 2005. Contractor and other requests for this document must
be referred to Commander, ATTN: ATSM-MA, U.S. Army Quartermaster Center and School, Fort
Lee, VA 23801-1601.
DESTRUCTION NOTICE: Destroy by any method that must prevent disclosure of contents or
reconstruction of the document.
*This publication supersedes FM 10-286, 30 June 1976.
i
Contents
Chapter 4 HUMAN OSTEOLOGY.......................................................................................4-1

Objective .............................................................................................................4-1
Glossary of Osteological Terminology ................................................................4-1
Adult Human Skeleton ........................................................................................4-4
Adult Postcranial Skeleton ................................................................................4-10
Fetal and Immature Skeleton............................................................................4-32
Chapter 5 DENTAL ANATOMY AND MORPHOLOGY......................................................5-1
Objective .............................................................................................................5-1
Glossary of Odontological and Anatomical Terminology....................................5-1
Tooth Surfaces....................................................................................................5-3
Teeth Classification.............................................................................................5-4
Universal Numbering System .............................................................................5-6
Deciduous Dentition............................................................................................5-7
Permanent Dentition ...........................................................................................5-7
Dental Caries ....................................................................................................5-14
Dental Restorations ..........................................................................................5-14
Dental Anomalies ..............................................................................................5-16
Chapter 6 BASIC MEDICOLEGAL DEATH INVESTIGATION ..........................................6-1
Objective .............................................................................................................6-1
Introduction .........................................................................................................6-1
Role of the Medicolegal Death Investigator ........................................................6-2
Chapter 7 EXAMINATION OF FLESHED REMAINS .........................................................7-1
Objective .............................................................................................................7-1
Scope of the Autopsy..........................................................................................7-1
Autopsy Procedures............................................................................................7-2
Biological Specimens..........................................................................................7-8
Chapter 8 PRIMARY IDENTIFICATION OF REMAINS......................................................8-1
Objective .............................................................................................................8-1
Dental Identification ............................................................................................8-1
Fingerprinting ......................................................................................................8-5
Fingerprinting Procedures.................................................................................8-11
Footprinting .......................................................................................................8-26
Deoxyribonucleic Acid (DNA) ...........................................................................8-26
DNA Harvesting ................................................................................................8-28
Chapter 9 IDENTIFICATION OF SKELETAL REMAINS ...................................................9-1
Objective .............................................................................................................9-1
Forensic Anthropology ........................................................................................9-1
Basic Laboratory Techniques .............................................................................9-2
Estimation of Skeletal Age ..................................................................................9-2
Determination of Adult Sex ...............................................................................9-11
Determination of Race ......................................................................................9-16
Estimation of Stature.........................................................................................9-17
Individualization.................................................................................................9-19
Video Superimposition and Facial Reconstruction ...........................................9-20
Appendix A PREPARATION OF DD FORM 890.................................................................. A-1
ii FM 4-20.65 27 July 2005

Contents
Appendix B PREPARATION OF DA FORM 4137 ................................................................B-1

Appendix C EVIDENCE COLLECTION AND PACKAGING GUIDE ....................................C-1
GLOSSARY ..........................................................................................Glossary-1
REFERENCES ..................................................................................References-1
INDEX..........................................................................................................Index-1
Figures
Figure 2-1. Anatomical position.............................................................................................. 2-2
Figure 2-2. Anatomical planes................................................................................................ 2-3
Figure 2-3. Directional terms ..................................................................................................2-4
Figure 2-4. The brain, gross, lateral view ............................................................................... 2-5
Figure 2-5. The brain, gross, superior view............................................................................ 2-5
Figure 2-6. Diagram of the lobes of the brain......................................................................... 2-5
Figure 2-7. The lungs, gross, lateral view .............................................................................. 2-6
Figure 2-8. The lungs, gross, medial view ............................................................................. 2-6
Figure 2-9. The heart, diagram of exterior structures............................................................. 2-7
Figure 2-10. The heart, gross................................................................................................. 2-7
Figure 2-11. The liver, gross, superior view ........................................................................... 2-8
Figure 2-12. The gallbladder, diagram of the exterior surface ............................................... 2-9
Figure 2-13. The gallbladder, gross ....................................................................................... 2-9
Figure 2-14. Upper abdominal viscera, gross, anterior view................................................2-10
Figure 2-15. The pancreas, gross ........................................................................................2-10
Figure 2-16. The spleen, anterior border, gross...................................................................2-11
Figure 2-17. The kidneys, cross section, gross, with abdominal aorta ................................2-12
Figure 2-18. Diagram of the urinary tract .............................................................................2-12
Figure 2-19. The esophagus and stomach, gross ...............................................................2-13
Figure 2-20. Diagram of the stomach...................................................................................2-14
Figure 2-21. Diagram of the small intestine .........................................................................2-14
Figure 2-22. Diagram of the large intestine..........................................................................2-15
Figure 2-23. Diagram of the large and small intestines .......................................................2-16
Figure 2-24. The appendix, gross ........................................................................................2-16
Figure 3-1. Cross section of the structures of the skin........................................................... 3-2
Figure 3-2. First degree burn..................................................................................................3-2
Figure 3-3. Second degree burn ............................................................................................ 3-3
Figure 3-4. Third degree burn ................................................................................................ 3-3
Figure 3-5. Fourth degree burn .............................................................................................. 3-4
Figure 3-6. Rule of nines ........................................................................................................ 3-5
Figure 3-7. Friction abrasion, the abdomen ...........................................................................3-7
27 July 2005 FM 4-20.65 iii

Contents
Figure 3-8. Pattern abrasion on lower leg that matches a screw-type bolt and washer
attached to the license plate of a car.................................................................. 3-7
Figure 3-9. Contusion ............................................................................................................ 3-8
Figure 3-10. Laceration.......................................................................................................... 3-8
Figure 3-11. Tapping fracture, femur ..................................................................................... 3-9
Figure 3-12. Crush fracture, calf (tibia and fibula) ............................................................... 3-10
Figure 3-13. Angulation fracture .......................................................................................... 3-10
Figure 3-14. Rotational fracture ........................................................................................... 3-11
Figure 3-15. Compression fracture ...................................................................................... 3-11
Figure 3-16. Depression fractures ....................................................................................... 3-12
Figure 3-17. Circular fracture ............................................................................................... 3-13
Figure 3-18. Stellate fracture ............................................................................................... 3-13
Figure 3-19. Stab wound to skin tissue................................................................................ 3-14
Figure 3-20. Incised wound to the arm ................................................................................ 3-15
Figure 3-21. Hesitation marks to the wrist ........................................................................... 3-15
Figure 3-22. Chop wound .................................................................................................... 3-16
Figure 3-23. Stellate gunshot entrance wound .................................................................... 3-17
Figure 3-24. Contact gunshot wound (left) and the muzzle of the weapon (right) .............. 3-17
Figure 3-25. Near contact gunshot wound to the chest....................................................... 3-18
Figure 3-26. Intermediate gunshot wound ........................................................................... 3-18
Figure 3-27. Distant gunshot wound.................................................................................... 3-19
Figure 3-28. Exit wounds to skin tissue ............................................................................... 3-19
Figure 3-29. Gunshot entrance wound ................................................................................ 3-20
Figure 3-30. Gunshot exit wound......................................................................................... 3-20
Figure 3-31. Petechiae of the eyeball .................................................................................. 3-21
Figure 4-1. Diaphysis and epiphyses of the right humerus ................................................... 4-2
Figure 4-2. Fontanelles .......................................................................................................... 4-3
Figure 4-3. The human skeleton ............................................................................................ 4-5
Figure 4-4. The skull, frontal view .......................................................................................... 4-6
Figure 4-5a. The skull, right lateral view ................................................................................ 4-7
Figure 4-5b. The skull, right lateral view ................................................................................ 4-7
Figure 4-6. The cranium, superior view ................................................................................. 4-8
Figure 4-7. The cranium, inferior view ................................................................................... 4-9
Figure 4-8. The hyoid bone.................................................................................................. 4-10
Figure 4-9. The vertebral column......................................................................................... 4-11
Figure 4-10. The atlas, C1, superior view............................................................................ 4-12
Figure 4-11. The axis, C2, superior view ............................................................................. 4-12
Figure 4-12. The seventh cervical vertebra, superior view.................................................. 4-12
Figure 4-13. Typical cervical vertebra, superior view .......................................................... 4-13
Figure 4-14. Typical thoracic vertebra, lateral view ............................................................. 4-13
Figure 4-15. Typical thoracic vertebra, superior view.......................................................... 4-14
iv FM 4-20.65 27 July 2005

Contents
Figure 4-16. Typical lumbar vertebra, lateral view ...............................................................4-14

Figure 4-17. Typical lumbar vertebra, superior view ............................................................4-14
Figure 4-18. The sternum, anterior view ..............................................................................4-15
Figure 4-19. A typical rib (left) ..............................................................................................4-15
Figure 4-20. The first right rib, superior view........................................................................4-16
Figure 4-21. The left scapula, anterior surface ....................................................................4-17
Figure 4-22. The left scapula, posterior surface...................................................................4-17
Figure 4-23. The left clavicle ................................................................................................4-18
Figure 4-24. The right humerus, anterior view .....................................................................4-18
Figure 4-25. The right humerus, posterior view ...................................................................4-19
Figure 4-26. The right radius, anterior view .........................................................................4-20
Figure 4-27. The right radius, posterior view........................................................................4-21
Figure 4-28. The right ulna, lateral view ...............................................................................4-21
Figure 4-29. The right ulna, anterior view ............................................................................4-22
Figure 4-30. The left hand, dorsal view ................................................................................4-23
Figure 4-31. The sacrum, ventral view .................................................................................4-24
Figure 4-32. The sacrum and coccyx, dorsal view...............................................................4-24
Figure 4-33. The right os coxa lateral view ..........................................................................4-25
Figure 4-34. The left os coxa, medial view...........................................................................4-25
Figure 4-35. The left femur, anterior view ............................................................................4-26
Figure 4-36. The right femur, posterior view ........................................................................4-27
Figure 4-37. The right patella, ventral view ..........................................................................4-27
Figure 4-38. The right patella, dorsal view ...........................................................................4-28
Figure 4-39. The right tibia, posterior view ...........................................................................4-28
Figure 4-40. The right tibia, anterior view.............................................................................4-29
Figure 4-41. The right fibula, dorsal view .............................................................................4-30
Figure 4-42. The right fibula, medial view ............................................................................4-31
Figure 4-43. The right foot, dorsal view................................................................................4-31
Figure 4-44. The fetal skeleton.............................................................................................4-32
Figure 4-45. From left to right: fetal femur diaphysis; juvenile femur with appearance
of epiphyses; adolescent femur; subadult femur; subadult femur (note
recent fusion of epiphysis to diaphysis); adult femur........................................4-33
Figure 5-1. Tooth anatomy ..................................................................................................... 5-3
Figure 5-2. Tooth surfaces .....................................................................................................5-4
Figure 5-3. Classification of deciduous dentition.................................................................... 5-5
Figure 5-4. Classification of the permanent dentition (maxillary) ........................................... 5-5
Figure 5-5. Maxillary permanent dentition .............................................................................. 5-6
Figure 5-6. Mandibular permanent dentition .......................................................................... 5-6
Figure 5-7. Deciduous dentition ............................................................................................. 5-7
Figure 5-8. Maxillary right central incisor ............................................................................... 5-8
Figure 5-9. Maxillary right lateral incisor................................................................................. 5-9
Figure 5-10. Maxillary left canine/cuspid ..............................................................................5-10
27 July 2005 FM 4-20.65 v

Contents
Figure 5-11. Maxillary left first premolar/bicuspid ................................................................ 5-11

Figure 5-12. Maxillary left second premolar/bicuspid .......................................................... 5-12
Figure 5-13. Mandibular right first molar.............................................................................. 5-12
Figure 5-14. Mandibular left second molar .......................................................................... 5-13
Figure 5-15. Mandibular right third molar............................................................................. 5-13
Figure 6-1. Floor plan method................................................................................................ 6-6
Figure 6-2. Exploded/cross-projection method ...................................................................... 6-6
Figure 6-3. Triangulation method........................................................................................... 6-7
Figure 7-1. The life cycle of the blowfly ................................................................................. 7-7
Figure 8-1. Periapical radiograph .......................................................................................... 8-3
Figure 8-2. Bitewing radiographs ........................................................................................... 8-3
Figure 8-3. Panoramic radiograph ......................................................................................... 8-4
Figure 8-4. Cross section of friction ridge skin ...................................................................... 8-6
Figure 8-5. Plain arch pattern ................................................................................................ 8-7
Figure 8-6. Tented arch patterns, type with an angle ............................................................ 8-8
Figure 8-7. Tented arch patterns, type with an upthrust........................................................ 8-8
Figure 8-8. Tented arch patterns, type resembling the loop.................................................. 8-8
Figure 8-9. Loop pattern ........................................................................................................ 8-9
Figure 8-10. Plain whorl pattern............................................................................................. 8-9
Figure 8-11. Central pocket loop whorl pattern ................................................................... 8-10
Figure 8-12. Double loop whorl pattern ............................................................................... 8-10
Figure 8-13. Accidental whorl pattern .................................................................................. 8-11
Figure 8-14. Fingerprint identification kit.............................................................................. 8-12
Figure 8-15a. Folding and placing fingerprint chart in tabletop cardholder ......................... 8-14
Figure 8-15b. Information block ........................................................................................... 8-14
Figure 8-15c. Positioning in cardholder ............................................................................... 8-15
Figure 8-16a. Inking finger ................................................................................................... 8-15
Figure 8-16b. Printing rolled impression .............................................................................. 8-16
Figure 8-17. Breaking rigor .................................................................................................. 8-17
Figure 8-18. Using the shovel-type cardholder.................................................................... 8-17
Figure 8-19a. Folding and placing fingerprint chart in shovel-type cardholder ................... 8-18
Figure 8-19b. Folding and placing fingerprint chart in shovel-type cardholder ................... 8-18
Figure 8-19c. Folding and placing fingerprint chart in shovel-type cardholder.................... 8-19
Figure 8-20. Injecting finger with tissue builder ................................................................... 8-19
Figure 8-21. Making deep cut at second joint to straighten finger....................................... 8-20
Figure 8-22. Removing pattern area from first joint ............................................................. 8-21
Figure 8-23. Fingertip skin trimmed and flattened between two pieces of glass before
being photographed ......................................................................................... 8-22
Figure 8-24. Ridge detail seen on dermis after charred epidermis removed ...................... 8-22
Figure 8-25. Epidermis mounted on glass slide photographed with back lighting .............. 8-26
Figure 8-26. The double helix .............................................................................................. 8-27
vi FM 4-20.65 27 July 2005

Contents
Figure 8-27. Eligible donors of mtDNA samples ..................................................................8-28

Figure 8-28. Removal of the index finger .............................................................................8-29
Figure 8-29. Fitzpak Transport Tube, DNA sample collection container .............................8-29
Figure 8-30. STP-100 Infectious Substance Shipper container...........................................8-30
Figure 8-31. STP-100 Infectious Substance Shipper with six transport tubes.....................8-30
Figure 8-32. STP-350 Saf-T-Case .......................................................................................8-30
Figure 8-33. STP-350 Saf-T-Case holding seven STP-100 Infectious Substance
Shipper containers ............................................................................................8-31
Figure 9-1. Keys to the recognition of patterns in os pubis (Line drawings by Deborah
Gray) ................................................................................................................... 9-7
Figure 9-2. Pubic symphysis morphology for female adult aging .......................................... 9-7
Figure 9-3. Pubic symphysis morphology for male adult aging ............................................. 9-8
Figure 9-4. Phase 0 ................................................................................................................ 9-9
Figure 9-5. Phase 1 ................................................................................................................ 9-9
Figure 9-6. Phase 4 ..............................................................................................................9-10
Figure 9-7. Phase 6 ..............................................................................................................9-10
Figure 9-8. Phase 8 ..............................................................................................................9-10
Figure 9-9. Pelvic elements ..................................................................................................9-12
Figure 9-10. Female pelvis ...................................................................................................9-12
Figure 9-11. Male pelvis .......................................................................................................9-12
Figure 9-12. Male pelvic traits ..............................................................................................9-13
Figure 9-13. Female pelvic trait............................................................................................9-13
Figure 9-14. Basic male and female cranial morphology.....................................................9-14
Figure 9-15. Male cranial morphology..................................................................................9-15
Figure 9-16. Female cranial morphology .............................................................................9-15
Figure 9-17. Measuring the maximum diameter of the femur head .....................................9-16
Figure 9-18. Cranial landmarks ............................................................................................9-17
Figure 9-19. Measuring the femur on the osteometric board...............................................9-18
Figure A-1. DD Form 890 .......................................................................................................A-3
Figure B-1. DA Form 4137 (front)...........................................................................................B-3
Figure B-2. DA Form 4137 (back) ..........................................................................................B-4
Figure C-1. Seal the package with evidence tape................................................................. C-1
Figure C-2. Druggist’s fold..................................................................................................... C-4
Tables
Table 9-1. Estimation of immature remains from epiphyseal union ....................................... 9-5
Table 9-2. Aging rules related to the Suchey-Brooks pubic age determination system ........ 9-9
Table 9-3. Male and female pelvic traits...............................................................................9-14
Table 9-4. Basic male and female cranial morphology ........................................................9-15
Table 9-5. Sex estimation using the humerus and femur ....................................................9-16
27 July 2005 FM 4-20.65 vii

Contents
Table 9-6. Race characteristics of the skull ......................................................................... 9-17

Table 9-7. Equations to estimate living stature (cm) for individuals between 18 and
30 years with standard errors from the long bones.......................................... 9-18
viii FM 4-20.65 27 July 2005

Preface
The mortuary affairs specialist (MOS 92M) performs or supervises duties relating to deceased personnel to
include recovery, collection, evacuation, establishment of tentative identification, and temporary burial. They
also inventory, safeguard, and evacuate personal effects of deceased personnel.
This FM addresses the basic procedures and methodologies used in processing human remains to support the
final identification of deceased military and civilian personnel. It pertains to all remains processed through U.S.
Army facilities during peacetime and wartime, both past and present.
Because of the complexity of the subject matter, procedures for identifying remains cannot be prescribed or
standardized. The classification of remains—recent, decomposed, semiskeletal, or skeletal—will dictate the
procedures that will be employed. However, this manual details standard identification procedures used to
arrive at a final identification for remains processed regardless of classification.
This FM begins with discussions of basic gross human anatomy, antemortem and perimortem trauma, human
osteology, and dental anatomy and morphology. These chapters provide the mortuary affairs specialist with the
basic knowledge to proficiently assist human identification experts (such as the forensic pathologist, medical
examiner, forensic odontologist, and forensic anthropologist) with identifying human remains.
Chapter 6 is a response to the AFMES policy that treats each battlefield fatality as a forensic MDI. This chapter
provides the mortuary affairs specialist with the knowledge of medical, legal, and scientific standards to ensure
that all crucial forensic evidence is preserved and documented in compliance with MDI standards during the
92M mission of search, recovery, evacuation, and tentative identification of remains.
Because the mortuary affairs specialist frequently assists in mortuaries in both the CONUS and OCONUS, this
FM ends with discussions on the procedures used by human identification experts (forensic pathologist,
medical examiner, forensic odontologist, fingerprints expert, DNA expert, and forensic anthropologist) to
identify human remains.
The scope and depth of this FM will make it useful to every mortuary affairs specialist, regardless of location.
This manual enables the reader to become conversant in the basic procedures and methodologies used in
identifying deceased military and civilian personnel.
This publication applies to the Active Army, the Army National Guard/the Army National Guard of the United
States, and the United States Army Reserve.
The proponent of this publication is the Headquarters, United States Army Training and Doctrine Command,
US Army Quartermaster Center and School. Send comments and recommendations on DA Form 2028
(Recommended Changes to Publications and Blank Forms) directly to—
Commander
U.S. Army Quartermaster Center and School
ATTN: ATSM-MA
Fort Lee, Virginia 23801-1601
Unless this publication states otherwise, masculine nouns or pronouns do not refer exclusively to men.
ix FM 4-20.65 27 July 2005

Acknowledgements
The copyright owners listed below have granted permission to reproduce their material.
The following figures are courtesy of Ms.Jeananda Col: figures 2-1 and 2–2.
The following figures are courtesy of Dr. Wesley Norman: figures 2-6 and 5-1.
The following figure is courtesy of Patrick J. Lynch, M.S.: figure 2-9.
The following figure is courtesy of Kelly J. Roberts: figure 3-1.
The following figures are courtesy of Dr. Edward Klatt: figures 3-19 and 3–23.
The following figures are courtesy of Daniel Maidman: figures 4-4 and 4-5.
The following figures are courtesy of Dr. Andrew M. Sklar: figures 8-1, 8-2, and 8-3.
The following figures are courtesy of Dr. Judy Suchey: figures 9-1, 9-2 and 9-3.
x FM 4-20.65 27 July 2005

Chapter 1
THE IDENTIFICATION PROCESS AND MORTUARY
PROTOCOLS
BACKGROUND
1-1. The process of identifying a deceased person begins when remains are recovered. Information from
witnesses, the decedent’s unit, and recovery personnel is documented by the mortuary affairs specialist. In
addition, requests are made for medical, dental, and fingerprint records as expeditiously as possible. This
information and recorded data are evaluated throughout the recovery, evacuation, and identification
processing stages. The remains and associated identifying media and personal effects are examined and the
findings documented. The completed documentation makes up the decedent’s IDPF. If the completed
documentation shows that a remains is that of a named individual or an individual of a group—and that all
reasonable doubts of the identity have been resolved—final disposition is made of the remains. If
completed documentation shows that the remains cannot be identified, the case is continued in an active
status so that further attempts at successful resolution can be made.
RESPONSIBILITIES
1-2. The CMAOC (U.S. Army Human Resources Command, under the general staff supervision of the
United States Army Adjutant General Directorate) has Army staff responsibility for the care and
disposition of remains.
1-3. The Deputy Chief of Staff of Logistics (G-4) is responsible for the search, recovery, evacuation,
tentative identification, processing, and/or temporary interment of remains in theaters of operations.
1-4. The Commander, United States Army Human Resources Command, exercises staff supervision and
administers all phases of the Army Mortuary Affairs Program. (Specific responsibilities are outlined in
AR 638-2, paragraph 1-4d.)
1-5. The responsibilities of commanders of major Army commands and major subordinate commands,
casualty area commanders, adjutant generals, directors of logistics in commands located outside the United
States, and heads of other organizations with responsibilities for the care and disposition of remains and
personal effects are found in AR 638-2, paragraph 1-4e-j.
1-6. U.S. Code, Title 10–Armed Forces, Subtitle A, Part II, Chapter 75, Subchapter 1, Section 1471
(forensic pathology investigations) defines the authority of the Armed Forces Medical Examiner to conduct
a forensic pathology investigation to determine the cause or manner of death of a deceased individual. The
investigation may include an autopsy of the decedent's remains.
1-7. Department of Defense Directive 5154.24, “Armed Forces Institute of Pathology (AFIP)” (October
2001) defines the mission, organization, management, responsibilities, functions, relationships, and
authorities of the AFIP. A significant portion of this directive provides authority for the AFIP, through the
Office of the Armed Forces Medical Examiner, to conduct autopsies and to identify military dead.
POLICIES FOR THE FORENSIC IDENTIFICATION OF REMAINS

1-8. The Commander, United States Army Human Resources Command (CDR, HRC, ALEXANDRIA
VA, ATTN: TAPC-PED) has established the following policies for identifying remains.
z Deceased personnel must be identified as quickly as possible by employing all well-known
means and scientific resources.
27 July 2005 FM 4-20.65 1-1

Chapter 1
z Multiple remains from a single incident will be processed for identification simultaneously.
z Commingled remains will not be arbitrarily separated.
z Remains will not be classified as unidentifiable until identification recommendations are
reviewed by the Casualty and Memorial Affairs Board of Officers and approved by the
Commander, United States Army Human Resources Command (CDR, HRC, ALEXANDRIA
VA, ATTN:TAPC-PED).
z Means used to establish identification will be documented carefully and accurately.
z Information concerning the identification or shipment of remains will not be released to news
media before establishing a final identification for all remains and notifying next of kin.
RECORDS
1-9. All remains case files and personal effects case files must be kept fully documented at all times.
Complete information on all actions taken pertinent to the investigation and resolution of a case must be a
matter of record and available for examination. Supporting documents—to include all original processing
forms, X-rays, fingerprint records, dental records, and copies of medical records—will be sent to CDR,
HRC, ALEXANDRIA, VA, ATTN: TAPC-PED, 2461 Eisenhower Ave., Alexandria, VA 22331-0481.
They will become part of the decedent’s IDPF.
EXAMINATING AND RECORDING DATA

1-10. Personnel engaged in processing operations must carefully examine and record exactly all
identification data associated with a remains. They must also preserve all identifying media (refer to
paragraph 1-25). These tasks are vital to final identification. Any item received with remains that may
furnish information that will lead to or confirm identification is completely described and recorded on DD
Form 890, Record of Identification Processing – Effects and Physical Data (refer to appendix A).
INDIVIDUAL CLOTHING AND EQUIPMENT

1-11. All items of individual clothing and equipment are carefully examined for clues that may be used in
the identification process.
1-12. All markings on clothing are examined visually. Clothing may be examined under an alternate light
source (a nonlaser based forensic light system) for evidence that is faint or not readily visible. Alternate
light sources have been used successfully for locating and photographing latent fingerprints, body fluids,
and other trace evidence (such as fibers, hair, gunshot residue, bone, and ink).
1-13. Official identification attached to the remains—such as identification tags, DD Form 1380 (U.S. Field
Medical Card), or death tags—is examined. Any discrepancies in information are entered on processing
records. Identification tags are imprinted in the space provided on DD Form 890. The identification tag is
attached to the remains in such a manner that will not forensically compromise the remains. The DD Form
1380 or the death tag is attached to the case papers.
1-14. Military equipment is examined for identification numbers assigned to the equipment. A complete
description of the equipment and the numbers assigned to the items are recorded. During this process, leave
equipment on the remains in its original position. Remove only those items of equipment which are
dangerous—such as weapons, ammunition, and explosives.
1-15. Military records are carefully examined. The name, grade, social security number, fingerprint record
and/or other data pertinent to the deceased are recorded.
1-16. All weapons and ammunition will be withdrawn and turned in to supply channels.
1-17. Organizational clothing will not be removed in the field.
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THE IDENTIFICATION PROCESS AND MORTUARY PROTOCOLS
PERSONAL EFFECTS
1-18. Procedures for disposing of personal effects of deceased and missing personnel are found in
AR 638-2 and DA Pam 638-2.
IDENTIFYING MEDIA
1-19. Certain categories of identifying media are acceptable to mortuary affairs personnel for the initial
association of remains with specific fatalities. These media are not, however, considered conclusive for
final identification.
SINGLE-ITEM MEDIA
1-20. Identification tags from around the neck, in the pockets, or elsewhere on the deceased.
1-21. An identification bracelet found on the wrist.
1-22. An official identification card found on the deceased [for example, DD Form 2 (Armed Forces of the
United States Identification Card) or its replacement the CAC].
Note. Visual recognition of remains must be done with extreme deliberation and care. The
identification must be based upon a close and direct examination of the remains by a person or
persons who knew the decedent well (roommate, squad leader, close friend). The certification of
this examination is recorded on DD Form 565 (Statement of Recognition of Deceased) which is
an enclosure to DA Form 2773, Statement of Identification (reference DA Pam 638-2, chapter 3,
paragraph 7, page 4).
COLLECTIVE MEDIA
1-23. When facts concerning the date, location, and unit of assignment of the deceased agree with a
known casualty record, the facts, combined with one or more of the following means of identification, are
used as the basis for the presumptive association of a remains with a fatality:
z Motor vehicle operator’s permit.
z Personal papers and letters, such as credit cards, a marriage certificate, a will, money orders, and
unofficial identification cards.
z Engraved jewelry.
z Information obtained from local officials and residents.
INCONCLUSIVE MEDIA
1-24. Media other than that listed under single-item media and collective media above are insufficient for
presumptive identification.
1-25. However, all records applicable to the deceased must bear the BTB identity and information
recorded on the records must support the BTB identity of the remains.
PROCESSING REMAINS
1-26. The procedures used when the remains are processed are recorded on DD Form 890 and on dental,
skeletal, anatomical, and fingerprint charts. (AR 638-2 is the prescribing directive for the DD Form 890
series.) Specific attention to detail and extreme care must be used in recording information on all forms. Be
aware that anatomical and dental charts are “transposed,” the right sides of the charts as the observer views
them represent the left side of a remains.
27 July 2005 FM 4-20.65 1-3

Chapter 1
CHAIN OF CUSTODY
1-27. When remains are received, in-processing personnel verify the information, sign the receipt, and
enter the information in a facility/mortuary register. Each remains is assigned a processing number and
tagged accordingly. An embossed or hand printed identification tag is attached to the pouch containing the
remains. All items (personal effects, identifying media) associated with the remains are properly tagged
and recorded. Proper documentation of remains and items is essential to maintain chain of custody. Chain
of custody provides a record of individuals that had original custody (possession) of the remains and items,
to whom the remains and items were transferred, the date(s) of transfer(s), and where the remains and items
were secured. Chain of custody provides accountability and ensures the integrity of the remains and items.
[Appendix B provides instructions for completing DA Form 4137 (Evidence/Property Custody
Document).]
z Initiate DD Form 890 and dental, skeletal, anatomical, and fingerprint charts.
z Examine clothing (refer to paragraphs 1-11 through 1-17) and record data on DD Form 890.
z Examine remains for identifying media and record data on DD Form 890.
z Examine remains for scars, tattoos, or other identifying marks/characteristics. Record data on
DD Form 890 and dental, skeletal, anatomical, and fingerprint charts as appropriate.
z Photograph the remains. Photographs include, but are not limited to—
Scars, tattoos, bone malformations, healed fractures, abnormal tooth formations, and
wounds.
Full face and profile views of current remains.
Fingerprints.
Personal effects bearing identification data.
Results of findings under the alternate light source.
1-28. Chart dental remains on a dental chart only when directed by and under the direct supervision of the
medical examiner. Ensure that the chart is complete, accurate, and detailed. Record defects and
restorations, wear, alignment, dentures, and bridges.
1-29. Chart skeletal remains on a skeletal chart only when directed by and under the direct supervision of
the medical examiner. The remains are laid out in anatomical order. Record missing skeletal elements or
portions of elements. Record type and location of fractures, deformities, and trauma. In recording skull
fractures, it should be noted that three views of the skull are typically illustrated. Therefore, skull fractures
affecting more than one view of the skull should be recorded to present a clear picture of the extent of
injury. For example, a fracture radiating from the left parietal bone across the frontal bone and ending in
the right parietal bone must be shown on all three views of the skull.
1-30. Complete an anatomical chart only when directed by and under the direct supervision of the medical
examiner. The condition of the remains is indicated in the space provided on the form. An accurate
description is recorded of all identifying media, such as tattoos, scars, birthmarks, deformities, wounds,
healed fractures, and injuries to include the exact location of these features on the remains. Photograph any
distinctive characteristics.
1-31. Record fingerprints on a fingerprint chart only when directed by and under the direct supervision of
the medical examiner. All remains are fingerprinted, if possible, regardless of other identifying media
present. Record impressions of all digits that will give a legible print. In cases where there is an indication
that the cause of death is due to other than natural causes or is of a questionable nature and may involve a
CID investigation, major case prints should be obtained from the deceased and released to the local CID
office. The major case prints (fingerprints, palm prints, fingertips, and sides of fingers and palms) will be
in addition to the fingerprints.
FOOTPRINTS
1-32. When the BTB remains are a pilot in one of the services, foot impressions are made, if possible.
(Record any available information about the decedent—including name, social security number, and
processing number—on the form. The form is secured to a clipboard.) Ink the toes and the balls of the feet
1-4 FM 4-20.65 27 July 2005

THE IDENTIFICATION PROCESS AND MORTUARY PROTOCOLS
with an inked roller. To place the impressions on a footprint chart, the operator grasps the foot firmly
across the instep and presses the clipboard against the entire foot at one time. Although it is not necessary
to get an impression of the entire foot surface, as much of it as possible should be obtained.
1-33. Request that the Director, CMAOC, provide medical and dental records of deceased personnel.
1-34. Ensure that all information on DD Form 890 and dental, skeletal, and anatomical charts is accurate to
aid in identifying the deceased.
1-35. All available supporting documents must accompany remains to the processing facility. Examples of
supporting documents most frequently used include, but are not limited to, DD Form 1380; DD Form 565;
DA Form 2773; DD Form 890; and dental, skeletal, anatomical, and fingerprint charts. Any additional
pertinent supporting documents may also accompany remains.
1-36. Submit documentation to proper authorities for approval and signatures as required.
1-37. Ensure that the chain of custody is signed when remains and personal effects are transferred at time
of disposition.
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Chapter 2
BASIC GROSS HUMAN ANATOMY
OBJECTIVE
2-1. To provide the mortuary affairs specialist with the knowledge to assist proficiently with autopsies of
fleshed remains.
GLOSSARY OF ANATOMICAL TERMINOLOGY

2-2. Anatomists and anthropologists use standardized anatomical terminology to describe the human
body and facilitate unambiguous communication among practitioners and researchers.
ANATOMY
2-3. Anatomy is the study of the structure of the body and the relationship of its parts to each other. The
term “anatomy” has a Greek origin that means "to cut up" or "to dissect."
z Gross anatomy. Gross anatomy deals with the naked-eye appearance of tissues and organs.
z Histology/microscopic histology. Histology is the branch of anatomy/biology that deals with the
minute structure of tissues, including the study of cells and organs.
ANATOMICAL POSITION
2-4. All descriptions of the human body are based on the assumption that the person is standing erect
with the hands at the sides and the face, feet, and palms directed forward (figure 2-1). The long bones are
not crossed. The various parts of the body are then described in relation to imaginary planes.
Understanding these planes will facilitate learning terms related to the position of structures relative to each
other.
27 July 2005 FM 4-20.65 2-1

Chapter 2
Figure 2-1. Anatomical position1
ANATOMICAL PLANES
2-5. Coronal (or frontal). This plane divides the body into symmetrical anterior (front) and posterior
(rear) halves. The coronal plane is placed at right angles to the sagittal plane. See figure 2-2.)
2-6. Sagittal (or median). This plane separates the body into symmetrical right and left halves.
2-7. Horizontal (or transverse). This plane divides the body into superior (upper) and inferior (lower)
parts. Unlike the coronal and sagittal planes, this plane can pass through the body at any height.
1
Ms. Jeananda Col.
2-2 FM 4-20.65 27 July 2005

Figure 2-2. Anatomical planes2
APPENDICULAR SKELETON
2-8. The appendicular skeleton includes the bones of the arms, legs, shoulder girdle, and pelvic girdle.
AXIAL SKELETON
2-9. The axial skeleton includes the bones of the head, vertebrae, ribs, and sternum.
TERMS OF DIRECTION OR RELATION FOR THE BODY AND THE SKELETON

2-10. See figure 2-3 for the following directional terms:
z Superior. Closer to the head. Reference point is the horizontal plane.
z Inferior. Closer to the feet. Reference point is the horizontal plane.
z Anterior (or ventral). Toward the front of the body. Reference point is the coronal plane.
z Posterior (or dorsal). Toward the back of the body. Reference point is the coronal plane.
z Medial. Toward the midline. Reference point is the sagittal plane.
z Lateral. Away from the midline. Reference point is the sagittal plane.
z Proximal. Nearest the axial skeleton or closer to the origin of a structure, near the trunk or head.
A term usually used for the limb bones. For example, the head of the humerus is the proximal
end.
2
Ms. Jeananda Col.
27 July 2005 FM 4-20.65 2-3

Chapter 2
z Distal. Farthest from the axial skeleton or further away from the origin of a structure. A term
usually used for the limb bones. For example, the distal humerus articulates with the (proximal)
ulna and radius.
z Palmar. The palm side of the hand, also known as volar.
z Plantar. The sole of the foot, also known as volar.
z Dorsal. The back side of the body, also known as posterior. The term “dorsal” also refers to the
top of the foot and the back of the hand.
z Endocranial. The inner surface of the cranial vault.
z Ectocranial. The outer surface of the cranial vault.
z Supine. Lying on the back with the face up.
z Prone. Lying on anterior surface of the body (stomach) with face down.
Figure 2-3. Directional terms
MAJOR INTERNAL ORGANS

THE BRAIN
2-11. The brain (figures 2-4 and 2-5) and the spinal cord make up the central nervous system. From the
outside, the brain appears as three distinct but connected parts—the cerebrum, the cerebellum, and the
medulla oblongata (the brain stem).
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Figure 2-4. The brain, gross, lateral view
Figure 2-5. The brain, gross, superior view
2-12. The cerebrum (figures 2-4 and 2-6) is the largest part of the brain and consists of two cerebral
hemispheres. Each hemisphere is large and almost symmetrical. They extend from the frontal to the
occipital bones. The surface of each hemisphere, the cortex, is composed of gray matter. The cerebral
cortex is made of folds (gyri) separated by fissures (sulci).
2-13. The sulci subdivide each hemisphere into lobes. The lobes correspond to the bone of the cranium
under which they lay—the frontal lobe, the parietal lobes, the temporal lobes, and the occipital lobe.
Figure 2-6. Diagram of the lobes of the brain3
2-14. The cerebellum (figures 2-4 and 2-6) is located at the base of the skull, beneath the occipital lobes.
Like the cerebrum, the surface layer is composed of gray matter (cortex). The cerebellum has a central
portion (vermis) and two side portions (hemispheres).
3
Dr. Wesley Norman.
27 July 2005 FM 4-20.65 2-5

Chapter 2
2-15. The medulla oblongata (figures 2-4 and 2-6) is conical in shape and is the lowest portion of the brain
stem. It connects the brain and the spinal cord. The medulla oblongata has a central core, also known as the
spinal bulb, which gradually becomes the spinal cord exiting the skull through the foramen magnum in the
occipital bone.
2-16. Three protective membranes—meninges—surround the brain. The outermost membrane, the dura
mater, is the toughest and thickest. Below the dura mater is a middle membrane, the arachnoid layer. The
pia mater, the innermost membrane, consists mainly of small blood vessels and closely follows the
contours of the surface of the brain.
THE LUNGS
2-17. The two lungs—one on each side of the sternum—are soft, spongy, and elastic (figures 2-7 and 2-8).
They are protected by the ribs. The external surface is smooth and is covered with a thin membrane
(visceral pleura). Each lung is conical in shape and consists of an apex, a base, three borders, and two
surfaces.
Figure 2-7. The lungs, gross, lateral view
Figure 2-8. The lungs, gross, medial view
2-18. The apex is blunt and broad and projects upward about one inch above the clavicle. The base is
broad, concave, and rests on the surface of the diaphragm. Each lung has an anterior, inferior, and posterior
border. The anterior surface (the costal surface) corresponds to the chest wall and is convex. The posterior
surface (mediastinal) is concave.
2-6 FM 4-20.65 27 July 2005

2-19. The right lung is slightly larger than the left lung. The right lung is divided into three lobes: the
upper, middle, and lower lobes. The left lung is divided into two lobes: the upper and lower lobes.
THE HEART
2-20. The average adult heart (figures 2-9 and 2-10) is a fist-sized muscular organ that weighs between 7
and 15 ounces. The heart is pyramidal in shape with an apex that is directed downward and forward. The
base of the heart is the posterior surface. The heart is located in the middle of the chest between the
lungs—behind and slightly left of the sternum. It rests in a moistened chamber called the pericardial cavity.
Figure 2-9. The heart, diagram of exterior structures4
Figure 2-10. The heart, gross
4
Patrick J. Lynch, M.S.
27 July 2005 FM 4-20.65 2-7

Chapter 2
2-21. The heart is primarily a shell, a hollow muscular organ, with four chambers inside that fill with
blood. The chambers are the right atrium, left atrium, right ventricle, and left ventricle. The right side and
left side of the heart each house one atrium and ventricle. The atria form the curved top of the heart. The
ventricles meet at the bottom of the heart to form a pointed base.
2-22. The superior border of the heart connects to a few large blood vessels (figure 2-9). The largest blood
vessel is an artery—the aorta, which carries nutrient-rich blood away from the heart to the rest of the body.
The pulmonary artery connects the heart with the lungs. The two largest veins that carry oxygen-poor
blood from the body to the heart are the superior vena cava and the inferior vena cava. The superior vena
cava is located near the top of the heart. The inferior vena cava is located beneath the superior vena cava.
THE LIVER
2-23. The liver (figure 2-11) is the largest gland in the body. It is located in the upper right-hand portion of
the abdominal cavity, beneath the diaphragm and on top of the stomach, right kidney, and intestines. The
greater part of the liver is situated under cover of the ribs. It is cone shaped, dark reddish brown, smooth
and firm to the touch, and weighs about 3 pounds.
Figure 2-11. The liver, gross, superior view
2-24. The liver consists of two main lobes, a right and a left lobe. Each lobe is made up of thousands of
lobules that are connected to small ducts that, in turn, connect with larger ducts to ultimately form the
hepatic duct. The hepatic duct transports the bile produced by the liver cells to the gallbladder and the first
part of the small intestine.
2-25. Many vital functions have been identified with the liver. Some of these include the production of
certain proteins, cholesterol, and immune factors; conversion of excess glucose; filtration of the blood to
remove bacteria and other foreign particles; regulation of blood clotting; regulation of most chemical levels
in the blood; and the production and secretion of bile. Bile is the greenish-yellow fluid (consisting of waste
products, cholesterol, and bile salts) that performs two primary functions—to carry away waste and to
break down fats during digestion.
2-26. At any given moment, the liver holds about one pint (13 percent) of the body’s blood supply. All the
blood leaving the stomach and intestines passes through the liver.
THE GALLBLADDER
2-27. The gallbladder (figures 2-12 and 2-13) is a pear-shaped, bluish-greenish sac hanging from the
underside of the right portion of the liver. It is about 4-inches long and about 1-inch wide.
2-8 FM 4-20.65 27 July 2005

Figure 2-12. The gallbladder, diagram of the exterior surface
Figure 2-13. The gallbladder, gross
2-28. The gallbladder is divided into the fundus, body, and neck (figure 2-12). The fundus is a broad
extremity that is directed downward and projects beyond the anterior border of the liver. The body and
neck are directed upward. The neck is continuous with the cystic duct.
2-29. The gallbladder concentrates and stores bile produced by the liver and delivers it to the duodenum
(the first part of the small intestine), where it aids in the digestion and absorption of fat (figure 2-14). The
gallbladder concentrates bile by removing water and storing it until a person eats. At this time, bile is
discharged from the gallbladder via the cystic duct into the duodenum where it begins to dissolve the fat in
ingested food.
27 July 2005 FM 4-20.65 2-9

Chapter 2
Figure 2-14. Upper abdominal viscera, gross, anterior view
THE PANCREAS
2-30. The pancreas (figure 2-15) is a soft, elongated, tapered organ located across the back of the
abdomen, behind the stomach. It is made up of glandular tissue and a system of ducts. The pancreas is light
tan or pinkish in color, between 5 and 6 inches in length, and approximately. ½- to 1-inch thick. The
pancreas is divided into a head, neck, body, and tail.
z The disc-shaped head is on the right extremity of the organ and lies within the curve of the
duodenum (the first part of the small intestine). The head is the widest part of the organ.
z The neck is a thin constricted section that connects the head to the body.
z The body is the middle part of the organ between the neck and tail. It runs upward and to the left
across the midline.
z The tail (left extremity) is the thin tip of the organ that is in contact with the spleen.
Figure 2-15. The pancreas, gross
2-31. Because the pancreas is composed of two types of tissues, exocrine tissue and endocrine tissue, it has
two different functions. The exocrine tissues secrete digestive enzymes, which help break down
carbohydrates, fats, proteins, and acids in the duodenum. The endocrine tissues secrete hormones that
regulate carbohydrate and fat metabolism and control the level of glucose in the blood.
2-10 FM 4-20.65 27 July 2005

THE SPLEEN
2-32. The spleen (figure 2-16) is a fist-sized organ, reddish to dark purplish in color. It is oblong, flattened,
soft, and highly vascular. The spleen is located in the upper left quadrant of the abdomen. It lies between
the stomach and the diaphragm.
Figure 2-16. The spleen, anterior border, gross
2-33. The spleen is part of the lymphatic and immune system. The spleen helps control the amount of
blood and blood cells that circulate through the body. It also removes damaged cells and bacteria from the
blood.
THE KIDNEYS
2-34. The two bean-shaped kidneys (figure 2-17), each about the size of an adult fist, are reddish-brown to
purplish-brown in color. Each kidney is about 4-inches high, 2-inches wide, 1- to 2-inches thick, and
weighs between 5 and 6 ounces. The lateral borders are convex and the medial borders are concave. They
are located at the back of the abdominal cavity, just below the ribs, toward the middle of the back. There is
one kidney on each side of the spinal column.
2-35. The kidneys function to remove liquid waste from the blood in the form of urine—
z To keep a stable balance of salts, water, and other substances in the blood.
z To regulate blood pressure.
z To produce a hormone that aids in forming red blood cells.
27 July 2005 FM 4-20.65 2-11

Chapter 2
Figure 2-17. The kidneys, cross section, gross, with abdominal aorta
THE URINARY BLADDER

2-36. The urinary bladder (figure 2-18), a hollow balloon-shaped sac with strong muscular walls, is
located immediately behind the pubic bones.
Figure 2-18. Diagram of the urinary tract
2-37. The empty urinary bladder is pyramidal in shape with an apex, a neck, a base, one superior surface,
and two inferolateral surfaces. The shape and size of the bladder are the same in both sexes. The empty
bladder is no larger than a tennis ball.
2-38. The apex of the urinary bladder is situated behind the upper margin of the pubic symphysis. The
base (posterior surface) is triangular. The ureters enter the bladder on the base at the sides. The ureters are
the long narrow tubes that carry the urine from the kidneys to the bladder. The urethra is the canal, located
in the neck of the bladder that discharges the urine.
2-39. The urinary bladder is a rather simple organ. It has two main functions—storage of urine and voiding
of urine. The amount of urine the bladder can store is about the same in men and women but varies
markedly between individuals. An average bladder holds about 2 cups of urine.
THE ESOPHAGUS
2-40. The esophagus is a long flexible muscular tube that connects the pharynx and the stomach
(figure 2-19). The length varies from person to person, but generally it is between 10- and 12-inches long.
2-12 FM 4-20.65 27 July 2005

2-41. The esophagus is made up of several muscle layers that contract in waves to push chewed food and
saliva into the stomach. The lower esophageal sphincter is a valve at the junction of the esophagus and
stomach. It stays closed most of the time but relaxes as chewed food approaches, allowing the food to pass
into the stomach. The sphincter functions to prevent food and acid from backing up into the esophagus.
THE STOMACH
2-42. The stomach (figure 2-19) is an expanded section of the digestive tube between the end of the
esophagus and the beginning of the small intestine in the upper part of the abdomen. Much of the stomach
lies under the cover of the lower ribs. Although the shape and position of the stomach are modified by
changes within itself and the surrounding viscera, it is roughly J-shaped. Variations in size and shape
depend on the volume of its contents, the position of the body, the stage of digestion, and the condition of
the adjacent intestines. When empty or almost empty (figure 2-19), the stomach contracts to form folds
(rugae).
Figure 2-19. The esophagus and stomach, gross
2-43. The stomach has two openings, two curvatures, and two surfaces.
2-44. The cardiac orifice is the opening where the esophagus enters the stomach. The pyloric orifice
articulates with the duodenum (figure 2-20). Its position is usually recognized by a slight constriction,
circular groove on the surface of the stomach.
2-45. The lesser curvature forms the right border of the stomach. It extends from the cardiac orifice to the
pylorus. The greater curvature is four or five times as long as the lesser curvature. It starts at the left of the
cardiac orifice and forms an arch across the stomach that ends to the most inferior part of the pylorus
(figure 2-20).
2-46. The stomach has an anterior and posterior surface. When the stomach is contracted, the surfaces are
positioned upward and downward. When the stomach is distended, the surfaces are positioned forward and
backward.
27 July 2005 FM 4-20.65 2-13

Chapter 2
Figure 2-20. Diagram of the stomach
2-47. For descriptive purposes, the stomach is divided into three major regions—the fundus, the body, and
the antrum (figure 2-20). The fundus is a dome-shaped, upward projection. The body extends from the
cardiac orifice to the lower portion of the lesser curvature. The antrum forms the lower portion of the
stomach. The pylorus is the most distal and tubular part of the stomach.
2-48. The stomach has three main functions—to store food, to process food, and to transport food. It stores
food immediately after swallowing; it mixes the food with gastric juice (which provides partial digestion)
to produce a semifluid substance called chime; and it controls the rate of delivery of the chyme to the small
intestine for efficient digestion and absorption.
THE SMALL INTESTINE

2-49. The small intestine (figure 2-21), between 18- and 23-feet long, is the longest section of the digestive
tube. It is located in the lower abdomen below the stomach. The small intestine is a folded muscular tube
comprised of three regions that form a passage from the pylorus to the large intestine. These sections are
the duodenum, the jejunum, and the ileum.
Figure 2-21. Diagram of the small intestine
2-50. The duodenum is a short (about 10 inches) C-shaped section that joins the stomach to the jejunum. It
is the shortest, widest, and most fixed portion of the small intestine. The duodenum is important because it
receives the openings of the bile and pancreatic ducts.
2-14 FM 4-20.65 27 July 2005

2-51. The jejunum and the ileum are difficult to distinguish from one another. Both are attached to the
posterior abdominal wall by mesentery (a folding membrane). There are some distinctive features, but the
change from one section to the other is gradual.
z The jejunum and the ileum are about 20 feet long. The upper two fifths (40 percent) of this
length is the jejunum. The lower 60 percent is the ileum.
z The jejunum lies in the upper part of the peritoneal cavity. The ileum is in the lower part of the
cavity and the pelvis.
z The jejunum is thicker walled and redder than the ileum.
z The ileum empties into the large intestine.
2-52. The small intestine’s primary function is the digestion and absorption of the products of digestion.
This is where approximately 99 percent of digestion takes place. It is here that the final stages of digestion
occur and many nutrients are absorbed by the small intestine.
THE LARGE INTESTINE

2-53. The large intestine (figure 2-22) is the portion of the digestive tube between the ileum and the anus.
It is about 4- to 5-feet long and forms an arch that surrounds the small intestine. It differs from the small
intestine in its greater diameter, its more fixed position, and the presence of many small sacs.
Figure 2-22. Diagram of the large intestine
2-54. Like the small intestine, the large intestine has three sections—the cecum, colon, and rectum.
z The cecum is the relatively large closed pouch in which the large intestine begins. It is about 2-
to 3-inches long.
z The colon is the longest part of the large intestine. Here much of the water and salt is extracted
from the undigested waste products and returned to the circulation transforming the liquid mass
to more solid feces. As it winds through the abdominal cavity, various portions are assigned
names corresponding to their relative position.
As the large intestine moves upward into the upper right portion of the abdomen just below
the liver, it is called the ascending colon.
When it curves at the liver and runs across the abdomen, it is referred to as the transverse
colon.
27 July 2005 FM 4-20.65 2-15

Chapter 2
As it curves down toward the rectum on the left side of the abdomen it is called the
descending colon.
z The rectum forms the last 5 to 7 inches of the large intestine. It terminates in the anal canal.
2-55. The large intestine has almost nothing to do with digestion. Its main function is absorbing water and
electrolytes from food residue passing through the intestines. The large intestine also stores undigested
material until it is eliminated as feces.
Figure 2-23. Diagram of the large and small intestines
THE APPENDIX
2-56. The appendix (figure 2-24) contains a large amount of lymphoid tissue. It is a worm-shaped hollow
tube that varies in length from 3 to 5 inches. The base is attached to the cecum where the small intestine
meets the cecum. The tip is free with a considerable range of motion and may be found in a variety of
positions.
Figure 2-24. The appendix, gross
2-57. The appendix is believed to be a remnant of an organ from human evolutionary past. As such, it may
be unnecessary in modern human anatomy.
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Chapter 3
ANTEMORTEM AND PERIMORTEM TRAUMA
OBJECTIVE
3-1. To provide the mortuary affairs specialist with the basic knowledge of wounds and injuries to
fleshed and skeletonized remains, to assist knowledgeably with autopsies, and to proficiently assist forensic
experts with skeletal and anatomical charts.
WOUNDS AND INJURIES

3-2. During the following descriptions of wounds and injuries, the reader should bear in mind that
injuries frequently do not occur in isolation. Any one individual can, and often will, display a combination
of different wound types and injuries. A wound is defined as any break in the skin or an organ caused by
violence, physical injury, or surgical intervention. An injury is defined as any physical damage caused by
violence, accident, or fracture, and so forth.
BURNS
3-3. Burns to skin tissue can occur from contact with a variety of sources—such as heat, fire, extreme
cold, electricity, hot liquids, radiation, and chemicals. Regardless of the source of the burn, all soft tissue
burns can be classified as either a first, second, third, or fourth degree burn. Figure 3-1 is a diagram of a
cross section of the two main layers of the skin. The epidermis is the outermost layer of the skin and covers
the dermis. The dermis is the active part of the skin containing the hair, muscles, blood supply, sebaceous
glands, and nerve receptors.
27 July 2005 FM 4-20.65 3-1

Chapter 3
Figure 3-1. Cross section of the structures of the skin5
First Degree Burns

3-4. First degree burns (figure 3-2) are superficial burns, affecting the outer layer of skin (epidermis). The
skin appears red or pink in color and may be mildly swollen. The epidermis is intact and there is no
blistering. First degree burns can be due to prolonged exposure to low-intensity heat or light. There is
usually peeling of the superficial skin cells. Sunburn is the most common kind of first degree burn.
Figure 3-2. First degree burn
Second Degree Burns

3-5. Second degree burns (figure 3-3) cause damage to the deepest layers of the dermis. The skin will
appear swollen and moist with blisters. Blisters are the distinguishing characteristic of second degree
burns. Second degree burns are subdivided into superficial and deep. Severe sunburn or scalding with hot
water will produce a second degree burn.
5
Kelly J. Roberts.
3-2 FM 4-20.65 27 July 2005

z Superficial second degree burns involve only the most superficial dermis. Blistering is present
and there may be sloughing of the overlying skin. Superficial second degree burns heal without
scarring.
z Deep second degree burns involve more of the epidermis and dermis. There is destruction of the
superficial underlying tissues. It may appear as a blister or a wound with a white or deep red
base. There may or may not be blistering. Deep second degree burns can cause permanent
scarring.
Figure 3-3. Second degree burn
Third Degree Burns

3-6. Third degree burns (figure 3-4) destroy the epidermis and dermis, extend to the subcutaneous layers,
and destroy skin tissue and structures. They may also destroy fat cells, nerve tissue, and muscles. Because
third degree burns destroy nerve endings, they are often “painless.” There are no blisters. The lesions may
look pearly-white and waxy or may appear dark brown or blackened with a leathery appearance due to
charring. Third degree burns cause dense scarring.
Figure 3-4. Third degree burn
Fourth Degree Burns

3-7. The term “fourth degree burn” is usually seen in an autopsy report. In fourth degree burns, the
injuries extend deeper than the skin. There is destruction of the epidermis and dermis—down to and past
the subcutaneous tissue. The nerves are burnt, so there is little associated pain. These burns injure and
expose muscle, bone, and tendons. Fourth degree burns are, for the most part, not compatible with survival.
If there is survival, then amputation of extremities is typically required. Fourth degree burns usually do not
occur until after death.
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Chapter 3
3-8. Fourth degree burns (figure 3-5) will create severe disfigurement of the remains and frequently cause
problems in identification. If the facial structures are mutilated and fingerprints are unobtainable, a dental
or DNA identification can be attempted.
Figure 3-5. Fourth degree burn
Pugilistic Posture
3-9. The pugilistic attitude/posture is a basic postmortem change often observed in such burn cases. (The
word “pugilist” is defined as a fighter especially a professional boxer.) Heat can cause the muscles of the
extremities to contract. The arms in particular will take on an altered appearance in which they are drawn
up with wrists curled, imitating a boxer’s stance. The muscular contractions, resulting in the pugilistic
posture, can cause fractures of the long bones and cranial vault. Caution should be used in these instances
as such fractures may be mistaken for antemortem violence on the body, particularly blunt force trauma.
Rules of Nines
3-10. In living individuals, the extent of burn is indicated by the “rule of nines.” Figure 3-6 demonstrates
this principle. The total body surface is designated as 100 percent. The extremities, head, and torso are
divided as follows; the head is 9 percent, each arm is 9 percent, the front of the torso is 18 percent, the back
is 18 percent, each leg is 18 percent and the groin is 1 percent.
3-4 FM 4-20.65 27 July 2005

Figure 3-6. Rule of nines
BLUNT FORCE INJURY

3-11. Blunt force injury/trauma is the result of applying force to a body with a blunt instrument. This can
occur in a number of ways. The body may be stationary and the blunt force may be mobile (standing
individual struck by a stone). The body may be in motion and the blunt force is stationary (individual
falling and striking concrete pavement). The body and the blunt force may both be mobile (two individuals
in a fight). Blunt injury/trauma includes beatings, kicking, blows from blunt instruments, falls, motor
vehicle accidents, and others. The severity, extent, and appearance of injuries due to blunt force trauma
depend upon—
z The amount of force delivered to the body.
z The amount of time it takes to deliver.
z The area of the body struck.
z The amount (extent) of body surface over which the force is delivered.
z The nature of the weapon.
27 July 2005 FM 4-20.65 3-5

Chapter 3
Note. Blunt force injuries may be present on either the external surface of body or internal
organs or both.
3-12. The more force that is used to deliver a blow, the greater the extent/severity of the trauma.
3-13. The amount of time it takes to deliver the blow will affect the extent of the injury. Any increase in
the period of time over which a blow is delivered will decrease the amount of energy (force) delivered by
the blow. (The slower a blow is delivered, the less severe the injury.) Conversely, any decrease in the
period of time over which a blow is delivered will increase the amount of force delivered by the blow. (The
faster a blow is delivered, the more severe the injury.)
3-14. Different regions of the body will respond differently to blunt force injuries. For example, a wound
inflicted from a blow delivered to the head (rounded portion of the body) will be more severe than a wound
inflicted by a blow to the back (flat portion of the body).
3-15. The amount of the body surface the injury is inflicted upon also affects the severity of the wound.
When a blow is inflicted over a large area, such as the back, the wound will be less severe than a blow to
the head because there is a larger area of contact and the force is dissipated over a broader area.
3-16. The nature of the weapon delivering the blow will affect the severity of the wound inflicted. Clearly,
a hammer or a metal rod can inflict more damage than a flat board.
3-17. The formula, W = E x (1/D) x (1/A) x K, allows for visualizing wound production: Wound = Energy
x (1/duration of application of the force) x (1/area of application) x K (modifying factors). A modifying
factor is anything that interferes or changes the original application of force, such as the weapon striking an
intermediate target or the body moving against the weapon.
BLUNT FORCE CATEGORIES

3-18. There are four categories of blunt force injuries—abrasions, contusions, and lacerations to the skin
and fractures of the skeletal system. It is possible that one injury will display a combination of injuries.
Abrasions
3-19. Abrasions (figure 3-7) are superficial injuries produced by excessive friction of the skin against
some object. These injuries are seen where an object, with an irregular or rough surface, has struck the skin
or where a person has fallen onto a rough surface. There is partial loss of the epidermis. Abrasions include
common scrapes, grazes, brush burns, scratches, and impact abrasions.
3-6 FM 4-20.65 27 July 2005

Figure 3-7. Friction abrasion, the abdomen
3-20. Antemortem abrasions are reddish brown in color. Abrasions can be produced postmortem. These
are brownish-yellow in color, are translucent, and have a parchment-like appearance. There is little or no
bleeding.
3-21. Abrasions will indicate to the forensic pathologist an area on the body where a blunt force or blunt
instrument has impacted the body. There may be a pattern to the abrasions from the striking object that
may suggest the type of weapon used. Abrasions can retain much of the surface characteristics of the object
that caused the injury. For example, there may be a patterned abrasion (figure 3-8) caused by a vehicle
involved in a “hit-and-run” accident, such as that made by a radiator grill or bumper. Tire tread imprints on
an individual involved in a hit-and-run are another example of an abrasion that was caused by “stamping”
an object against the skin. Belt buckles, ropes, fingers, sticks, pipes, and steering wheels can all leave
distinctive abrasion patterns on skin.
Figure 3-8. Pattern abrasion on lower leg that matches a screw-type bolt
and washer attached to the license plate of a car
Contusion
3-22. A contusion (figure 3-9) is an injury caused by an injury/blow in which the skin is not broken. The
striking force will cause the blood vessels beneath the skin to break resulting in a bruise. The localized
collection of blood in the area of the contusion is called a hematoma. Contusions can be present on both
skin and internal organs. Contusions, like abrasions, can be patterned depending on the object that struck
the skin.
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Chapter 3
Figure 3-9. Contusion
3-23. Contusions (bruises) change color over time as they heal. Immediately the bruise will appear purple,
dark blue, or red. During the course of healing, it will change to violet, green, and then yellow. The color
yellow indicates about 18 hours or more of healing. Other color changes are not predictive. In 13 to 18
days the skin will return to normal.
3-24. Like abrasions, contusions indicate a blunt force to a particular area. However, a contusion will be
larger than the weapon/object that produced it because the blood has seeped into the surrounding tissues
after rupture of the blood vessels. Thus, a contusion will not always indicate the exact point of trauma.
Because a bruise is larger than the object that produced it, it is not possible to correlate the exact size of the
object to the size of the bruise. For example, in a linear bruise, such as when an individual is struck with a
board or pipe, one can measure the width of the bruise to estimate the width of the weapon.
Laceration
3-25. A laceration (figure 3-10) is the tearing of the skin following crushing or shearing forces. These
injuries are caused by forcible contact with a blunt object, falls, or impact with vehicles. There is a tear in
the tissue and the edges are irregular. Often incomplete tearing of the tissue occurs and blood vessels
and/or nerves can be seen extending from one edge of the laceration to the other. This condition is called
“bridging.” The edges usually show some degree of contusion or abrasion. Bridging of tissue is the factor
differentiating a laceration from an incised wound. Like contusions, there can be lacerations of both the
skin and internal organs.
Figure 3-10. Laceration
3-26. Examination of lacerations may determine the nature of the object/weapon used, the amount of force
applied, and the direction of the force. Foreign substances may have been deposited in the wound by the
object/weapon or the surface that caused the laceration. Foreign substances may provide for trace elemental
analysis as an aid in crime reconstruction.
3-27. There may not, however, be an exact correspondence between the shape of the weapon/object and
the shape of the laceration. Generally long, thin objects (such as pipes and pool cues) tend to produce
3-8 FM 4-20.65 27 July 2005

linear lacerations. A blunt object with a round edge (such as a ball peen hammer) will produce a stellate
(star-shaped) laceration. A blunt object with an edge (such as a typical hammer) will produce a crescent-
shaped laceration. Objects with flat surfaces tend to produce irregular, ragged, or Y-shaped lacerations.
Fracture
3-28. A fracture is a break in the bone. The most common designations of fractures are simple (closed),
compound (open), and greenstick. In a simple fracture, the skin is not broken. In a compound fracture, the
bone has broken through the skin and is exposed on the surface. A greenstick fracture is an incomplete
break of a long bone. One side of the bone is bent inward and the other side is broken outward. Greenstick
fractures are common in children, rare in adults. Bone fractures are produced by either direct or indirect
trauma.
Direct Fractures
3-29. Direct fractures are caused by direct application of force to the fracture site. The force (object) may
strike a slow or nonmoving body or a moving body may strike a slow or nonmoving object. Direct
fractures are divided into tapping (focal), crush, and penetrating fractures.
z Tapping (focal) fractures (figure 3-11) result from a force of dying momentum over a small
area, such as a blow from a kick or a stick. There is very little soft tissue damage—although a
small area of tissue may be split or bruised. There will be a transverse fracture line. If the blow
is to an area where two bones are adjacent to each other (such as the forearm or the calf) usually
only one bone will be fractured.
Figure 3-11. Tapping fracture, femur

z A crush fracture (figure 3-12) is the result of a large force over a large area. There is extensive
soft tissue damage, and there are multiple breaks with splintering or fragmentation of the bone.
A crush fracture is, in reality, a massive comminuted fracture. When the trauma is to an area
where two bones are adjacent to each other (such as the forearm or calf) both bones fracture at
the same level.
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Chapter 3
Figure 3-12. Crush fracture, calf (tibia and fibula)

z A penetrating fracture is the result of a large force upon a small area. The bone is crushed
and/or splintered. In reality, penetrating fractures are synonymous with gunshot wounds.
Indirect Fractures
3-30. Indirect fractures are produced by a force acting at a distance from the fracture site. Indirect fractures
are classified as traction/tension, angulation, rotational, and compression fractures. There are also
combinations of the above resulting in angulation and compression fractures and angulation, rotation, and
compression fractures.
z In tension (traction) fractures the bone is pulled apart by traction. The shaft of a long bone is
not likely to be pulled apart. The fracture typically occurs at a joint. The joint is forcefully
flexed while the muscles are contracting. In pure tension, the damage is to joints and ligaments.
The bone may not be involved. When the bone is fractured, common sites are the patella, the
olecranon process of the ulna, and the medial malleolus of the tibia. The fracture line is
transverse.
z In angulation fractures (figure 3-13) the bone bends until it snaps. There is usually a transverse
fracture on one side of the bone with splintering of the bone on the other side. The fragments lie
at an angle to each other.
Figure 3-13. Angulation fracture
3-10 FM 4-20.65 27 July 2005

z In rotational fractures (figure 3-14) the bone is twisted and a spiral, often ragged, fracture
results. Imagine a piece of chalk that is twisted until it breaks. A characteristic spiral fracture
line is produced that makes one complete rotation around the circumference of the chalk.
Figure 3-14. Rotational fracture

z Compression fractures (figure 3-15) of the long bones produce T-shaped or Y-shaped fractures
due to the hard shaft being driven into the cancellous ends. These fractures are usually observed
at the distal ends of the bones. Compression fractures are commonly found in the spine and
occur when the vertebrae collapse from their normal height of an inch or so to about half that
size.
Figure 3-15. Compression fracture
BLUNT FORCE INJURY TO THE SKULL

3-31. Blunt force injury to the skull is caused when an object strikes the head or when the head strikes an
object (such as when an individual falls and the head strikes a concrete pavement). Blunt force injuries to
the scalp, lacerations, abrasions, and contusions have been covered in paragraph 3-18. Therefore, this
section will deal solely with the effects of blunt force injuries to the skull.
3-32. Numerous factors affect the severity, extent, and appearance of skull injuries due to blunt force
trauma. These factors include the amount of force applied to the skull; the time over which the force was
delivered; the size, shape, weight, and consistency of the impacting object; and the contour and thickness
of the skull at the point of impact.
27 July 2005 FM 4-20.65 3-11

Chapter 3
z Regardless of the combination of the above factors, there is one consistency in blunt force
trauma to the skull. When a blow is delivered to any region of the skull, the skull flattens and
bends inward at point of impact. Regions that border the impact area bend outward. Outward
bending of the skull may occur at a considerable distance from the point of impact.
z The region of inward bending is usually flat, circular, oval, or stellate and always surrounds the
area where the blow was received. The inward bending area may confirm to the weapon used.
For example, if the skull is struck with a broad, flat surface, the skull will flatten out to conform
to the shape of the impact surface. If a skull is struck with a hammer, a circular depressed
fracture will occur.
z Where the skull is less curved, there is more inward bending and outward bending than in areas
where the skull curves sharply.
z A blunt force trauma does not always produce a fracture.
3-33. Blunt force injuries to the skull are classified as depression fractures, comminuted fractures, linear
fractures, circular fractures, stellate fractures, and diastatic fractures.
Depression Fracture
3-34. Depression fractures (figure 3-16) develop when a heavy object strikes forcefully over a small
surface. The bone is pushed inward and is depressed below the normal level. The appearance is a shallow,
concave “pond.” Depression fractures may only involve the outer table of bone—leaving the inner table
intact. Alternately, the velocity of the force may be sufficient to involve both the outer and inner tables.
Depending on the nature of the blunt force trauma and the bone impacted, there may or may not be linear
fracture lines radiating from the area of depression.
Figure 3-16. Depression fractures
3-35. A grazing (low velocity) blow to the occipital bone (dense bone) may result in only a depressed area
of bone.
3-36. A forceful blow to the parietal bone (less dense bone) may result in a depressed area as well as
fracturing. When there is sufficient force to produce fracturing, there will be radial fracture lines extending
outward from the center of impact. There may or may not be linear fractures.
Comminuted Fracture
3-37. In comminuted fractures the bone is fragmented. The type of striking force is similar to that causing
a depression fracture, but the force is spread over a broader area. The fractured area is wider than it is deep.
3-12 FM 4-20.65 27 July 2005

Linear Fracture
3-38. A linear fracture (figure 3-16) is a simple longitudinal fracture line or crack. The fracture actually
originates from the outbended area and extends toward the area of impact and in the opposite direction.
Thus, the fracture may occur some distance from the point of impact. Simple linear fractures typically
occur in low-velocity impacts with a large contact area between the head and the striking object (such as
traffic accidents and falls).
Circular Fracture
3-39. Circular fractures (figure 3-17) exhibit concentric or circular fracture lines encircling the point of
impact. They are accompanied by radiating fractures.
Figure 3-17. Circular fracture
Stellate Fractures
3-40. In stellate fractures (figure 3-18) there is a star-shaped injury at the point of impact with multiple
radiating linear fractures. The fracture lines originate around the point of impact. Heavy loads of relatively
low velocity are a common cause of stellate fractures.
Figure 3-18. Stellate fracture
Diastatic Fracture
3-41. Diastatic fractures are fractures that travel along the sutures and separate them.
3-42. In skulls in which the sutures are not completely fused, the sutures represent areas of weakness.
Diastatic fractures are most common in children. Diastatic fractures may also be observed in adult victims
of gunshot wounds.
SHARP FORCE INJURY

3-43. Sharp force injuries are produced by sharp-edged objects and typically present a clean appearance.
The edges are usually clean, sharp, and not crushed. They are differentiated from blunt force injuries in that
they lack ragged edges, marginal abrasions, and vessels that bridge the wound.
27 July 2005 FM 4-20.65 3-13

Chapter 3
3-44. Sharp force injuries are divided into three categories, stab (cut) wounds, incised wounds, and chop
wounds. Some experts include therapeutic/diagnostic wounds under sharp force injuries. These are wounds
produced by medical personnel during patient treatment.
Stab Wounds
3-45. Stab wounds (figure 3-19) to tissue are wounds where the depth of the injury is greater than the
length. Because muscle and skin contract around the wound, stab wounds are smaller on the outside but
deeper on the inside. Knives are most often used to inflict stab wounds, but bayonets, swords, machetes,
screwdrivers, scissors, glass, forks, pens, and pencils also cause them.
Figure 3-19. Stab wound to skin tissue6
3-46. The size and shape of a stab wound in the skin depends upon the weapon, the direction the weapon
entered the body, movement of the weapon, and movement of the individual stabbed. The sharpness and
design of the weapon will determine the appearance of the wound margins. The stab wound may be sharp
and regular, abraded and bruised, or jagged and contused.
3-47. Most experts agree that caution should be employed when rendering an opinion as to the
characteristics of a knife used to inflict a fatal stab wound in soft tissue. It is generally not possible to
definitely link a knife to a wound unless the knife has broken and a portion of the knife was recovered in
the body. The most information that can be inferred is the maximum width of the blade, an approximation
of the length, and if it is single edged.
3-48. Stab wounds to bone can be either superficial or deep. A stab wound will puncture, nick, or gouge
the bone as it enters the body. Because bone is rigid, it maintains the dimension and shape of a stab wound
far better than skin. The edges of a stab wound are typically clean and sharp and the bone is bent inward to
conform loosely to the contour of the stabbing weapon. It is often possible to determine the type of weapon
used by examining the wound in bone, especially the skull. A stab wound defect in a skull will match the
width and thickness of the knife blade. It is often possible to distinguish between a single-edged and
double-edged blade and a serrated edge versus a straight-edged blade in knife wounds to the bone. Some
cutting tools (such as chain saws and hacksaws) leave striations on bone which can be matched with the
weapon.
6
Dr. Edward Klatt.
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Incised Wounds
3-49. Incised wounds (cuts) (figure 3-20) are usually superficial and produced by sharp objects—such as
razors, knives, glass, metal, and even paper. The incision is longer than it is deep. The edges are typically
uniform, straight, clean cut, and clear of abrasions and contusions. Because incised wounds are created by
drawing a sharp edge along the skin, the wound will typically begin superficial, deepen, and end
superficial. The shape of an incised wound will not provide information on the weapon used.
Figure 3-20. Incised wound to the arm
Hesitation Marks
3-50. Hesitation marks (figure 3-21) are self-inflicted incised wounds that are typically observed on
suicide victims. These are multiple superficial wounds usually seen on the wrists, neck, left chest in the
area of the heart, or near the wound that proved to be fatal. Hesitation marks often do not go through the
skin. Parallel scars may be evidence of previous self-destructive behavior but are not necessarily evidence
of suicidal ideation.
Figure 3-21. Hesitation marks to the wrist
3-51. Victims of assaults can sustain sharp force injuries as they attempt to defend themselves. These
defense wounds can be either incised or stab wounds. They are typically inflicted on the upper extremities
(particularly on the palms of the hands and the backs of the forearms) when an individual attempts to ward
off a sharp-edged weapon.
Chop Wounds
3-52. Heavy instruments with at least one “sharp” cutting edge produce chop wounds. Instruments that
produce chop wounds include axes, machetes, cleavers, and propeller blades of boats. Some experts
categorize chop wounds as intermediate between sharp force and blunt force injuries.
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Chapter 3
3-53. Most chop wounds in tissue have an incised appearance. However, in a chop wound the instrument
will not only divide soft tissue but will also crush the margins of the tissue and fracture and/or damage
underlying bone.
3-54. A chop wound to the skull (figure 3-22) will have a deep linear impression with crushing of the
edges of the wound. The fracture or damage (crushing, cutting, or fragmentation) to the underlying bone
distinguishes a chop wound from an incised wound.
Figure 3-22. Chop wound
GUNSHOT WOUNDS
3-55. Gunshot wounds are classified as grazing, penetrating, or perforating. At times a combination of
gunshot wounds can occur in the same individual. A penetrating wound occurs when a low-velocity bullet
enters tissue and is retained in the tissue. A perforating wound occurs when the bullet passes completely
through the tissue.
3-56. Gunshot wounds are divided into four broad categories, which reflect the distance of the body from
the weapon. These categories are contact, near contact, intermediate (medium range), and distant. When a
weapon is fired, the bullet, gases from combustion, primer components, and burnt and unburnt powder are
propelled out of the muzzle at the same time. The patterns these elements produce on the skin are used to
determine the range of fire.
Contact Gunshot Wound

3-57. A contact gunshot wound occurs when the muzzle of the weapon is placed in direct contact with the
surface of the body at time of discharge. The hot gases and particulate matter are blasted into the body at
the same time as the bullet. In all contact wounds, the hot gases char the tissues. The gunpowder and metal
fragments are deposited in and along the wound track or on the skin surface. Gunpowder blackening is
present, but no tattooing or stippling (see below). There is usually an impression of the muzzle burned
around the entrance wound.
3-58. Contact gunshot wounds over the skull can give rise to a stellate (figure 3-23) or lacerated
appearance in the tissue, due to the expansion and tearing of tissues by gases being blown into the wound.
3-16 FM 4-20.65 27 July 2005

Figure 3-23. Stellate gunshot entrance wound7
3-59. Contact gunshot wounds (figure 3-24) leave a round or oval central defect, abrasion collar where the
bullet abraded the skin surface as it passed through it. There is a circular bruise over the skin due to muzzle
impact. The size of the defect is comparable to the size of the muzzle opening or bore of the weapon.
Figure 3-24. Contact gunshot wound (left) and the muzzle of the weapon (right)
Near Contact Gunshot Wound

3-60. In near contact gunshot wounds (figure 3-25) the muzzle of the weapon is not in contact with the
body, but a short distance away. The entrance wound will show similar features to the contact gunshot
wound except for the absence of the muzzle imprint. There is a larger central defect (entrance wound)
surrounded by a wide zone of powder soot over blackened skin—fouling. (Fouling is caused by soot that
travels a short distance from the gun barrel and is deposited on the skin.)
7
Dr. EdwardKlatt.
27 July 2005 FM 4-20.65 3-17

Chapter 3
Figure 3-25. Near contact gunshot wound to the chest
3-61. Near contact wounds caused by a pistol produce a dense zone of stippling with a wide soot deposit.
The entrance defect is not large and there is no laceration of the surrounding skin.
3-62. Rifle wounds cause devastating contact injuries of the head but will also cause entrance lacerations
or micro tears at a distance. Near contact wounds of the chest or abdomen with a rifle or shotgun may not
lacerate due to the ability of the chest and abdominal cavities to distend and the increased thickness of
subcutaneous tissues to displace pressure.
Intermediate Gunshot Wound

3-63. In intermediate (medium range) (figure 3-26) gunshot wounds the distance is too far for soot to
travel but not too far for powder grains to travel. Hot fragments of unburned gunpowder and small metal
fragments follow the bullet and produce numerous small, dry, reddish orange or brown pinpoint burns
around the entrance wound—stippling. Stippling without soot deposition (also referred to as tattooing) is
indicative of intermediate wounds.
Figure 3-26. Intermediate gunshot wound
Distant Gunshot Wound

3-64. The only marks on the body in distant gunshot wounds (figure 3-27) are those of the bullet
penetrating the skin. The distance is too far for either soot or gunpowder to travel. The wound margins are
clean; there is no fouling or stippling. Classically, the entrance wound is a central hole with scalloped
margins and an abrasion ring around the entrance hole. The exit wound lacks abrasion.
3-18 FM 4-20.65 27 July 2005

Figure 3-27. Distant gunshot wound
Gunshot Entrance and Exit Wound

3-65. Gunshot entrance wounds and exit wounds can usually be easily differentiated in both tissue and
bone. The entry wound is typically small, round to oval in shape, and sharp edged. The exit wound is often
considerably larger (figures 3-28 through 3-30).
3-66. Entrance wounds typically share similar characteristics. In tissue, they are normally round or oval
and sharp edged. There is a rim of flattened, abraded skin surrounding the entrance hole (the abrasion
ring), which will have a punched-out appearance. The abrasion ring is caused by the bullet scraping and
perforating the skin. The defect will be smaller than the diameter of the bullet due to the constriction of the
surrounding skin and muscle. Entrance wounds on the palms of the hands or soles of the feet may be slit-
like and much smaller than the bullet.
3-67. Exit wounds in tissue are usually larger and more irregular than entrance wounds. They may be slit-
like or have ragged edges. There is no abrasion ring in the skin. If the exit wound is shored by clothing or a
hard surface, there will be an abrasion of varying size around the defect.
Figure 3-28. Exit wounds to skin tissue
3-68. When a bullet enters the skull, it leaves a round or oval sharp-edged, punched-out hole on the
outside of the skull (figure 3-29). On the inside of the skull, the entrance hole will be larger and beveled.
When the bullet exits the skull, the inner table is now the “entrance” surface and the outer table is the exit
surface. Therefore, the inner table of an exit wound will have relatively round sharp-edged appearance and
the outer table will display a cone-like exit wound. The “textbook” identifier of an entrance wound to the
27 July 2005 FM 4-20.65 3-19

Chapter 3
skull is internal beveling. The “textbook” identifier of an exit wound to the skull is external beveling. The
exit wound has a cone-like appearance (figure 3-30).
Figure 3-29. Gunshot entrance wound
Figure 3-30. Gunshot exit wound
3-69. A high velocity projectile will cause greater and more rapid fracturing than a low velocity projectile.
High-power weapons—such as rifles—release high velocity projectiles. As the projectile enters the skull,
there is a sudden expansion of bone that results in a “starburst” wound. There are numerous cracks
radiating out from the point of impact. Low-power weapons—such as pistols—release low velocity
projectiles. The wound is typically a simple entrance wound, but there may be fracturing, especially with
wounds to the skull. There may or may not be an exit wound.
3-70. Artillery and mortar rounds tend to produce fragments and shrapnel between .07 and 3.0 grams.
Those from grenades and landmines are smaller, approximately 0.59 grams and rarely over 1.0 grams.
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Shrapnel may cause laceration wounds or penetrating injury or contusions, fractures, or abrasions, or a
combination of injuries.
ASPHYXIA
3-71. Asphyxia is a broad term that refers to a state in which the body becomes deprived of oxygen while
in excess of carbon dioxide. This state will lead to loss of consciousness and/or death. The classic signs of
asphyxia are—
z An abnormal accumulation of fluid (congestion) within the face and organs.
z Cyanosis—a bluish-purple discoloration of the skin and mucous membranes due to reduction in
oxygen carrying hemoglobin in the blood.
z Petechiae—small, pinpoint, dark red spots directly beneath the skin surface and the mucous
membrane covering the anterior portion of the eyeball (conjunctiva) (figure 3-31). The petchiae
are caused by the rupture of the small vessels, which bleed into the tissues.
Figure 3-31. Petechiae of the eyeball
3-72. Deaths from asphyxia are classified as suffocation, strangulation, and chemical asphyxia.
SUFFOCATION
3-73. In suffocation deaths, oxygen fails to reach the blood. Suffocation can occur from smothering,
choking, positional asphyxia (when individuals get into a position in which they cannot breathe), or when
oxygen has been displaced from the air by suffocating gases.
STRANGULATION
3-74. In strangulation deaths, external pressure on the neck closes the blood vessels and air passages of the
neck preventing passage of blood and air to the brain. There are three forms of strangulation deaths—
hanging, ligature strangulation (application of a constricting band to the neck, the force applied in any
manner other than by body weight), and manual strangulation (pressure by hands or forearm against the
neck).
CHEMICAL ASPHYXIA
3-75. Chemical asphyxia is caused by anything that inhibits the ability of the cells to use oxygen. The most
common chemical asphyxiants are carbon monoxide and cyanide.
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Chapter 3
Carbon Monoxide
3-76. Carbon monoxide is colorless, odorless, and tasteless. Most casualties of fire are due to inhaling CO
rather than thermal injuries. CO deaths from defective heaters and automobile exhaust are also common.
3-77. In death by carbon monoxide poisoning in Caucasoid individuals, the skin takes on a cherry red or
bright pink appearance. In individuals with dark skin pigmentation, the cherry red coloration is prominent
in the nail beds, mucosa of the lips, and the conjunctivae. In autopsy the muscles, organs, and blood will
also have a bright cherry red coloration.
Cyanide
3-78. A cherry red or pink lividity indicates a cyanide death. Cyanide has an aroma of bitter almonds.
DROWNING
3-79. Drowning is death due to submersion. Water or liquid is inhaled into the airways, blocking passage
of air to the lungs. In “wet” drowning, inhaling water causes choking. Hypoxia (reduction of oxygen to
tissue) causes breathing to cease and brain death occurs with the shutdown of the respiratory center.
Victims are identifiable by a “foam cone” or froth covering the mouth and nostrils. “Dry” drowning occurs
when the larynx spasms and the water never enters the lungs. “Dry” drowning was developed to explain
drowning where there was no pulmonary edema or foam/froth. Some experts believe that “dry” drowning
is the result of arrhythmia, an abnormal rate of muscle contractions in the heart.
3-80. In autopsy there is no absolute test to determine if an individual has died from drowning. The
diagnosis is made based on the circumstances of death, investigative reports, witness statements, and
generally nonspecific findings. If an individual is found in a river and all other causes of death have been
ruled out, then that individual is presumed to have died from drowning. Some nonspecific findings include:
foam in the mouth, nostril, and airways; skin wrinkling (“washerwoman” appearance); water in the
stomach and lungs; foreign material in the mouth, airways, lungs, and gastrointestinal tract; eyelid
petechiae; and middle ear hemorrhage.
3-81. Rigor mortis (see chapter 7) may start early because of violent struggling at the time of drowning.
When an individual drowns, the body sinks, the head is down, and the extremities are dangling downward.
Thus, postmortem lividity (which is often light red in color) is most noted in the head and upper chest,
hands, lower arms, feet, and calves due to the posture of the body while submerged.
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Chapter 4
HUMAN OSTEOLOGY
OBJECTIVE
4-1. To provide mortuary affairs specialists with knowledge of the human skeletal systems to assist
proficiently in recovering disassociated skeletal remains.
GLOSSARY OF OSTEOLOGICAL TERMINOLOGY

4-2. Anatomists and anthropologists use a specific standardized vocabulary to describe the human
skeletal system. Standardized terminology facilitates unambiguous communication among all researchers.
ALVEOLAR PROCESS
4-3. The alveolar process is the ridge of bone in the maxilla and mandible that contains the alveoli.
ALVEOLUS (SINGULAR); ALVEOLI (PLURAL)

4-4. The alveolus is a single tooth socket; the cavity in which the root of a tooth is held in the alveolar
process.
APPENDICULAR SKELETON
4-5. The appendicular skeleton includes the bones of the limbs (arms and legs), pelvic girdle, and
pectoral (shoulder) girdle.
ARTICULATE
4-6. Articulate (verb). To come into contact with.
ARTICULATION
4-7. Articulation (noun). The area where two or more bones or skeletal parts come in contact with one
another, such as joints and sutures. For example, the synovial joints provide a structure where bones abut
against and move about one another.
AXIAL SKELETON
4-8. The axial skeleton includes the bones of the head, vertebrae, ribs, and sternum.
BOSS
4-9. A boss is a rounded eminence usually used in reference to the shape of the frontal or parietal bones
of the skull.
CONDYLE
4-10. A condyle is a rounded projection for articulation with another bone.
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Chapter 4
CREST
4-11. A crest is a narrow, usually prominent ridge of bone.
DEGENERATIVE CHANGES
4-12. Degenerative changes are those which occur in the human skeleton after the skeleton has finished
growth and development. These changes are basically ones of erosion and general deterioration and
ossification of otherwise soft tissue.
DIAPHYSIS
4-13. The diaphysis is the long straight section (shaft) of a long bone (figure 4-1). It is the extension of the
primary ossification center of the long bone.
Figure 4-1. Diaphysis and epiphyses of the right humerus
EMINENCE
4-14. An eminence is a bony projection that is usually not as prominent as a process.
EPIPHYSEAL CLOSURE
4-15. Epiphyseal closure is the fusion of the epiphysis with the diaphysis that occurs during growth.
EPIPHYSIS (SINGULAR); EPIPHYSES (PLURAL)

4-16. The end of a long bone that is originally separated from the diaphysis by a layer of cartilage but that
later becomes united to the diaphysis through ossification (figure 4-1).
FONTANELLE
4-17. In an infant, the cranial bones are not joined together firmly at birth. The spaces where two sutures
intersect form a membrane-covered "soft spot" called a fontanelle (fontanel). The fontanelles allow the
birth canal the possibility of accommodating the neonates head during birth and for the growth of the skull
during an infant’s first year. There are five fontanelles—the anterior, posterior, mastoid, sphenoid, and
metopic fontanelle (figure 4-2).
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HUMAN OSTEOLOGY
Figure 4-2. Fontanelles
FORAMEN
4-18. A foramen is a round or oval hole, an opening. The foramen magnum is the large hole in the base of
the skull through which the spinal cord passes.
FORENSIC ANTHROPOLOGIST
4-19. Forensic anthropologists are specialists in the human skeletal system. They have advanced training
in human anatomy and all aspects of the human skeleton. They combine their knowledge of human
anatomy and the human skeleton to evaluate skeletonized or partially skeletonized remains in a legal
context.
FUSE/FUSION (OR UNION)

4-20. When the epiphyses of the bones unite (ossify) to their respective elements.
HEAD
4-21. A head is the large, rounded articular end of a long bone, such as in the head of the humerus and the
head of the femur.
MORPHOLOGY
4-22. Morphology is the branch of biology which deals with structure and form. In osteology, it refers to
the shape and size of a bone or its general appearance.
NECK
4-23. The neck is the constricted portion of bone between the head of a long bone and the shaft.
OSSIFICATION
4-24. Ossification is the formation of bone, the conversion of cartilage into bone (mineralization).
OSTEOLOGY
4-25. Osteology is the detailed study and analysis of bones and the skeletal system.
PROCESS
4-26. A process is a bony projection or prominence.
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Chapter 4
SINUS
4-27. A sinus is a cavity within a cranial bone.
SPINE
4-28. A spine is a long, thin, sharp projection.
STATURE
4-29. Stature is the height of any animal while standing.
SYMPHYSIS (SINGULAR); SYMPHYSES (PLURAL)

4-30. A symphysis is the line or junction formed by a cartilaginous articulation, the most common being
between the two bones of the pelvis and the two halves of the mandible.
SUTURE
4-31. A suture is a specially serrated and interlocking joint where the adjacent bones of the skull meet.
TROCHANTER
4-32. A trochanter is a large roughened prominence for the attachment of muscles, specifically one of two
processes found on the femur for the attachment of rotator muscles.
TUBEROSITY
4-33. A tuberosity is a roughened, rounded protuberance, such as those found on the humerus.
TUBERCLE
4-34. Tubercle is a small, roughened, rounded eminence.
ADULT HUMAN SKELETON

4-35. Other than dental enamel, bone is one of the strongest biological materials in existence and is the
main supporting tissue of the body. Bone is very lightweight and constitutes less than 20 percent of the
weight of the human body. There are typically 206 bones in the adult human skeleton (figure 4-3). Bones
grow and change during the life of an individual. As a result, bones vary like people do. The shape and size
of bones can differ dramatically between individuals. Individual bones are identified on the basis of their
size and shape. The long bones are the bones of the arms and legs which act as levers to produce motion
when acted upon by muscles. Short bones are strong and compact and located in the wrist and ankle. Flat
bones, like the scapulae and sternum, form protective plates and provide broad surfaces for muscle
attachments. Irregular bones, like the vertebrae, have many surfaces and articulate at many points.
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HUMAN OSTEOLOGY
Figure 4-3. The human skeleton
4-36. The adult skull, comprised of 28 individual bones, is the most complex element of the skeleton.
Many of the cranial bones are fused in the adult skull and do not appear as individual bones and are
difficult to distinguish. The skull is the bony protection for the brain and the organs of sense. Technically
the term “skull” refers to the entire bony framework of the head and mandible (lower jaw). The cranium is
the skull minus the mandible. The calvarium is the cranium without the face.
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Chapter 4
Frontal Bone
4-37. The frontal bone (unpaired) (figures 4-4, 4-5, and 4-6) is one of the largest and most robust bones of
the skull. It is the anterior portion of the skull and curves downward to form the upper margins of the
orbits. The frontal bone articulates with the parietal, ethmoid, lacrimal, nasal, and zygomatic bones and the
sphenoid and maxillae.
Figure 4-4. The skull, frontal view 8
8
Daniel Maidman.
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HUMAN OSTEOLOGY
Figure 4-5a. The skull, right lateral view 9
Figure 4-5b. The skull, right lateral view 10
9
Daniel Maidman.
10
Daniel Maidman.
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Chapter 4
Figure 4-6. The cranium, superior view
Parietal Bone
4-38. The parietal bones (paired) (figures 4-4, 4-5, and 4-6) form a large portion of the sides and roof of
the skull. Each parietal bone lies between the frontal and the occipital bone. They are the largest bones of
the cranium and are relatively square in shape. Each parietal bone articulates with the other parietal bone at
the roof of the cranium (midline) along the sagittal suture. They articulate with the occipital bone along the
lambdoid suture, with the frontal bone along the coronal suture, with the temporal bone at the squamosal
suture, and with the sphenoid.
Temporal Bone
4-39. The temporal bones (paired) (figures 4-5 and 4-6) are located at the sides and base of the cranium.
Each temporal bone holds three auditory ossicles, the bones of hearing, and provides the articulations for
the mandible. Each temporal bone articulates with a parietal bone, the occipital bone, sphenoid, zygomatic
bone, and mandible.
Occipital Bone
4-40. The occipital bone (unpaired) (figures 4-5, 4-6, and 4-7) forms the posterior, inferior part of the
cranium. The foramen magnum, the hole through which the spinal cord enters the cranium, is located here.
The occipital articulates with the parietal bones, the temporal bones, the sphenoid, and through the
occipital condyles with the first cervical vertebrae.
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HUMAN OSTEOLOGY
Figure 4-7. The cranium, inferior view
Maxillae (Plural) Maxilla (Singular) Bone

4-41. The maxillae (paired,) (figures 4-4 and 4-5) are the large bones that support the upper teeth and help
to form the lower margins of the orbits, the nasal opening, and the anterior portion of the hard palate (roof
of the mouth). The maxillae articulate with each other at midline and with the frontal bones, nasal bones,
lacrimal bones, ethmoid, inferior nasal conchae, palatine bones, vomer, zygomatic bones, and the sphenoid.
Palatine Bone
4-42. The palatine bones (paired) (figure 4-7) form the posterior portion of the hard palate and part of the
wall and floor of the nasal cavity. These bones are small, delicate, and L-shaped.
Nasal Bone
4-43. The nasal bones (paired) (figures 4-4 and 4-5) are small, rectangular bones that form the bridge of
the nose. They articulate with each other at midline, with the frontal bone at the nasal bridge, and with the
maxillae.
Lacrimal Bone
4-44. The lacrimal bones (paired) (figure 4-5) are very small delicate, rectangular-shaped bones that form
the anterior portions of the medial eye sockets. A small groove between the orbit and the nasal cavity
serves as a pathway for a tube that carries tears from the eyes.
Ethmoid Bone
4-45. The ethmoid bone (unpaired) (figure 4-5) is a light and delicate bone that is located midline between
the orbits. It forms part of the roof of the nasal cavity.
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Chapter 4
Inferior Nasal Conchae Bone

4-46. The inferior nasal conchae (paired) are located along the lateral walls of the nasal cavity. They are
very fragile, thin, curved bones that support the mucous membranes that line the nasal cavity. These
membranes aid in the sense of smell and in moistening inhaled air.
Vomer Bone
4-47. The vomer (unpaired) is a small, thin flat plow-shaped bone. It is located between the nasal cavities
and joins with the ethmoid to form the inferior and posterior portions of the nasal septum respectively.
Zygomatic Bone
4-48. The zygomatic bones (paired) (figures 4-4, 4-5, and 4-7) are also known as the malars. These
triangular bones are on both sides of the face below the eyes. They form the sides of the orbits and
“cheekbones.” Each zygomatic bone articulates with a temporal bone, maxilla, frontal bone, and sphenoid.
Sphenoid Bone
4-49. The sphenoid (unpaired) (figure 4-5) is a very irregular and complex bone that helps form the base
and sides of the cranial vault and the floors and sides of the orbits. It articulates with 12 bones. The name
“sphenoid” means wedge like. The sphenoid is composed of a body, two pairs of lateral expansions called
greater and lesser wings, and a pair of downward projecting processes (pterygoid plates). The saddle-
shaped, midportion of the sphenoid (the sella turcica) houses the pituitary gland.
Mandible Bone
4-50. The mandible (lower jaw) (figures 4-4 and 4-5) is the strongest bone of the face. It holds the lower
teeth. The mandible has two upright projections called rami. (Ramus is singular.) Each ramus has a
mandibular condyle that articulates with the temporal bone. Each ramus also has a coronoid process that
serves as a place of attachment for the chewing muscles.
ADULT POSTCRANIAL SKELETON

HYOID BONE
4-51. The hyoid bone is a U-shaped bone located in the neck (figure 4-8). The hyoid does not articulate
with another bone. It supports the tongue, and provides attachment for several muscles.
Figure 4-8. The hyoid bone
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HUMAN OSTEOLOGY
VERTEBRAL COLUMN
4-52. The vertebral column protects the spinal cord and supports the weight of the head and trunk
(figure 4-9). The vertebral column is usually composed of 33 elements. The upper 24 elements are separate
movable vertebrae that are normally associated with the vertebral column. The sacrum (five elements) and
coccyx (four elements) may fuse in adulthood to form an immovable bone. However, the coccyx does not
always fuse to the sacrum. The sacrum and the coccyx will be described below in relation to the pelvis. The
upper 24 vertebrae are divided into cervical (seven elements), thoracic (12 elements), and lumbar (five
elements) vertebrae.
Figure 4-9. The vertebral column
Cervical Vertebrae
4-53. The seven cervical vertebrae (C1-C7) are the smallest of the vertebrae and provide a great deal of
flexibility. Two cervical vertebrae are unique—the first cervical vertebra (the atlas) and the second (the
axis) cervical vertebra. The remaining five (C3-C7) share similar anatomical features.
4-54. The atlas (C1) has no body and no spinous process (figure 4-10). It is basically a ring upon which the
condyles of the occipital bone rest. It consists of anterior and posterior arches and a lateral mass on each
side. When the head moves up and down it does so mainly at this joint.
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Chapter 4
Figure 4-10. The atlas, C1, superior view
4-55. The axis (C2) has a peg-shaped (odontoid) process that acts as a pivot for the skull to rotate about
when the head turns from side to side (figure 4-11).
Figure 4-11. The axis, C2, superior view
4-56. The seventh cervical vertebra (C7) is the largest of the cervical vertebrae (figure 4-12) and is,
therefore, easily distinguished from the other cervical vertebrae. It has the largest body and the longest
spinous process. Because C7 is transitional between the cervical and thoracic vertebrae, it exhibits
characteristics of both.
Figure 4-12. The seventh cervical vertebra, superior view
4-57. All cervical vertebrae have transverse foramina for the vertebral arteries (figure 4-13). The spinous
processes are short and small and project posteriorly. The body is small and broader in a medial-lateral
(side to side) direction than in an anterior-posterior (front to back) direction. The vertebral foramen is large
and rather triangular in shape. The transverse processes are small. The cervical vertebrae increase in size
from above downward.
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HUMAN OSTEOLOGY
Figure 4-13. Typical cervical vertebra, superior view
Thoracic Vertebrae
4-58. The 12 thoracic vertebrae (T1-T12) support and articulate with the ribs (figures 4-14 and 4-15). Thus
thoracic vertebrae can be distinguished by the presence of costal rib facets on each side of the vertebral
body where the heads of the ribs articulate. There are costal articulations on the transverse processes where
the tubercles of the ribs articulate. The bodies are heart-shaped and increase in size from above downward.
There are no transverse foramina. The vertebral foramina are relatively small and circular. The spinous
processes are long, straight, and narrow and project inferiorly.
Figure 4-14. Typical thoracic vertebra, lateral view
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Chapter 4
Figure 4-15. Typical thoracic vertebra, superior view
Lumbar Vertebrae
4-59. The five lumbar vertebrae (L1-L5) are the largest of the vertebrae (figures 4-16 and 4-17). The
bodies are large and roughly kidney-shaped. Like the cervical and thoracic vertebrae, the lumbar vertebrae
increase in size from above downward. There are no transverse foramina and no costal facets. The spinous
processes are large, short and blunt and give a rectangular-like appearance.
Figure 4-16. Typical lumbar vertebra, lateral view
Figure 4-17. Typical lumbar vertebra, superior view
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HUMAN OSTEOLOGY
STERNUM
4-60. The sternum (breastbone) is a flat bone located in the midline of the chest, immediately beneath the
skin (figure 4-18). The sternum is made up of three parts—the manubrium (superior), the body as the main
portion, and the xiphoid process (inferior). The first seven ribs articulate with the manubrium and the body
via cartilage at the costal notches. The medial end of each clavicle articulates with the manubrium. The
xiphoid process anchors the muscles that are responsible for much of the muscular expansion and
contraction of the abdomen.
Figure 4-18. The sternum, anterior view
4-61. There are 12 pairs of ribs that articulate with the thoracic vertebrae. The first seven pairs (ribs 1
through 7) are termed “true” ribs as they articulate directly with the sternum via cartilage. Ribs 8, 9, and 10
are termed “false” ribs as they attach ventrally to each other and the seventh rib by common cartilages.
Ribs 11 and 12 are termed “floating” ribs, as the ventral ends are free-floating.
4-62. The typical rib is a long, twisted, flat bone with a round, smooth superior border and a sharp inferior
border (figure 4-19). A rib has a head, neck, tubercle, and a shaft (or body). The head is dorsal and has two
facets for articulation with the thoracic vertebrae. The neck is the constricted portion between the head and
the tubercle. The tubercle is a prominence on the outer surface of the rib at the junction of the neck with the
shaft. The shaft is the thin, curved, tapering portion between the tubercle and the ventral (sternal) end of
the rib.
Figure 4-19. A typical rib (left)
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Chapter 4
4-63. The first rib is atypical. It is the most curved, broadest, and shortest of the ribs (figure 4-20). It is
flattened superoinferiorly (from above downward). The head usually only has one articular facet. The
superior surface is roughened by muscle attachments and contains two shallow grooves, one each for the
subclavian vein and artery.
Figure 4-20. The first right rib, superior view
SCAPULA
4-64. The scapula (shoulder blade) is a large, flat, triangular bone (figures 4-21 and 4-22). It lies on the
dorsal side of the thorax between the second and seventh rib. The scapula has two surfaces (anterior and
posterior), three borders, and two processes. The borders are the vertebral (medial) border, which is the
longest and thinnest; the axillary (lateral) border, which is the thickest; and the superior border, which is
the shortest. On the dorsal surface is the spine, a process that runs laterally and ends in the acromion
(which articulates with the clavicle). The coracoid process projects anteriorly from the superior border and
provides attachment for muscles and ligaments. The scapula articulates with the humerus through the
glenoid cavity.
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HUMAN OSTEOLOGY
Figure 4-21. The left scapula, anterior surface
Figure 4-22. The left scapula, posterior surface
CLAVICLE
4-65. The clavicle (collar bone) is a long, tubular, curving, S-shaped bone (figure 4-23). It is situated just
above the first rib on each side of the rib cage. The medial end is rounded and the lateral end is flattened.
The clavicle articulates medially with the manubrium and laterally with the acromion process of the
scapula. The clavicle acts as a brace for the scapula and provides attachment for muscles. Each respective
clavicle and scapula together forms the pectoral (shoulder) girdle.
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Chapter 4
Figure 4-23. The left clavicle
HUMERUS
4-66. The humerus is the bone of the upper arm (figures 4-24 and 4-25). It is the largest and longest bone
in the upper extremity. The proximal end of the humerus consists of a head (which articulates with the
glenoid cavity of the scapula), a neck, and the greater and lesser tubercles. The deltoid tuberosity, the area
for attachment of the deltoid muscle, is located approximately on the proximal one third of lateral shaft.
The lateral and medial epicondlyes provide attachments for muscles and ligaments. The capitulum is a
rounded eminence for articulation with the radius. The trochlea is a spool-shaped eminence for articulation
with the ulna. The olecranon fossa accommodates the olecranon process of the ulna when the forearm is
extended.
Figure 4-24. The right humerus, anterior view
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HUMAN OSTEOLOGY
Figure 4-25. The right humerus, posterior view
RADIUS
4-67. The radius is on the lateral (thumb) side of the lower arm when the arm is in anatomical position
(figures 4-26 and 4-27). When the arm is pronated (palm turned down) the radius crosses over the ulna.
The radius is the shortest of the three arm bones. Distinguishing features of the proximal radius include the
head and the radial tuberosity. The head is rounded and concave and articulates with the capitulum of the
humerus. The radial tuberosity is a roughened area for muscle attachment. Distinguishing features of the
distal radius include the styloid process and the ulnar notch. The styloid process is a projection on the
lateral side. The ulnar notch is on the medial side for articulation with the ulna. The distal end articulates
with two carpal (wrist) bones. The interosseous crest is the sharp medial edge of the shaft.
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Chapter 4
Figure 4-26. The right radius, anterior view
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HUMAN OSTEOLOGY
Figure 4-27. The right radius, posterior view
ULNA
4-68. The ulna is the longest and thinnest of the bones of the forearm (figures 4-28 and 4-29). The
proximal shaft is large but tapers to a small distal end. In anatomical position, it is on the medial (little
finger) side of the forearm. Proximally, the ulna articulates with the humerus at the trochlea and laterally
with the radius at both the proximal and distal ends. The olecranon process—the large, irregular C-shaped
proximal end—fits into the olecranon fossa of the humerus. The distal shaft is small and consists of the
small rounded head. The styloid process projects from the medial aspect. The interosseous crest is the
sharp lateral edge of the shaft.
Figure 4-28. The right ulna, lateral view
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Chapter 4
Figure 4-29. The right ulna, anterior view
HAND
4-69. Each hand consists of 27 bones, which are categorized as carpals, metacarpals, and phalanges
(figure 4-30).
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HUMAN OSTEOLOGY
Figure 4-30. The left hand, dorsal view
4-70. The eight carpal bones together form the carpus (wrist). Each carpal bone is unique with numerous
articular surfaces. They articulate with the radius and the metacarpals.
4-71. There are five metacarpal bones in the palm. They are numbered one through five, starting on the
“thumb” side with number one and ending on the “little finger” side with number five. Each is cylindrical
in shape and presents a head, a shaft, and a base. The heads are the rounded distal ends (which form the
‘knuckles’ when a fist is made). The bases are the proximal square-like ends that articulate with the carpal
bones.
4-72. Each hand has 14 hand phalanges (the finger bones). The phalanges of digits two through five are
arranged in three rows—proximal, middle, and distal. The first metacarpal (thumb) has two phalanges—
proximal and distal. (The singular of phalanges is phalanx.)
PELVIC GIRDLE
4-73. The sacrum, the coccyx, and the os coxae form the pelvic girdle.
Sacrum
4-74. The sacrum is typically composed of five separate vertebrae that fuse during adulthood into an
immobile bone (figures 4-31 and 4-32). It is a large, wedge-shaped bone that is concave ventrally. There
are four foramina that perforate the sacrum and through which pass the sacral nerves. The superior border
articulates with the fifth lumbar vertebra. The ala is wing-like lateral projection off the first sacral element.
Laterally the sacrum articulates with the os coxa at the sacroiliac joint. Inferiorly the sacrum articulates
with the coccyx. There is a median crest (spine) on the dorsal aspect of the sacrum, which is formed by the
fusion of the spinous processes of the vertebrae. Beneath this crest is the sacral canal, which holds nerve
roots.
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Chapter 4
Figure 4-31. The sacrum, ventral view
Occyx
4-75. The coccyx (tail bone) is highly variable in shape (figure 4-32). It can consist of three to five
segments with four elements representing the norm. Pelvic muscles and ligaments attach to the coccyx. The
elements of the coccyx can, but do not always, fuse with each other and the sacrum.
Figure 4-32. The sacrum and coccyx, dorsal view
Os coxa
4-76. The os coxa (hip/pelvis) is a large irregular bone that has at times been called the innominate—
meaning nameless—because it does not resemble any common object. The os coxae (plural) articulate with
the sacrum and with each other. Each os coxa is composed of an ilium, ischium, and pubis (figures 4-33
and 4-34).
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HUMAN OSTEOLOGY
Figure 4-33. The right os coxa lateral view
Figure 4-34. The left os coxa, medial view
4-77. The ilium is the largest portion of the os coxa. It is the upper broad, flattened, blade-like portion of
the bone. The ilium flares outward to give the hip prominence. The superior border of the ilium is called
the iliac crest. The auricular surface articulates with the sacrum.
4-78. The ischium is the L-shaped inferior, posterior portion of the bone. The ischial tuberosity is blunt
and thick and bears the weight when sitting.
4-79. The pubis is the anterior portion of the os coxa. It contains the pubic symphysis, the surface where
the os coxae articulate with one another. The ilium, ischium, and pubis meet and join to form the
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Chapter 4
acetabulum. The acetabulum is the socket of the hip that faces laterally and articulates with the head of the
femur.
FEMUR
4-80. The femur (thigh bone) is the largest, heaviest, longest, and strongest bone in the body (figures 4-35
and 4-36). Proximally, the femoral head articulates with the acetabulum. Proximal characteristics are the
head, neck and the greater and lesser trochanters—large eminences, which provide places for muscle
attachments. Distally it articulates with the patella and proximal tibia. The anterior shaft is smooth and
rounded. The linea aspera is a wide crest or ridge on the posterior shaft that serves as a place of attachment
for several muscles. Distally the femur has lateral and medial condyles. The patellar surface separates the
condyles on the anterior surface. The intercondylar notch (or fossa) separates the condyles on the posterior
surface.
Figure 4-35. The left femur, anterior view
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HUMAN OSTEOLOGY
Figure 4-36. The right femur, posterior view
PATELLA
4-81. The patella (kneecap) is a small triangular sesamoid bone—a bone that develops in a tendon that
moves over a bony surface (figures 4-37 and 4-38). The apex points inferiorly. The thick base is proximal.
The dorsal surface articulates with the patellar surface of the femur.
Figure 4-37. The right patella, ventral view
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Chapter 4
Figure 4-38. The right patella, dorsal view
TIBIA
4-82. The tibia (shinbone) is the medial and larger bone of the lower leg (figures 4-39 and 4-40).
Proximally, the medial and lateral condyles articulate with the condyles of the distal femur. The inferior
lateral aspect of the lateral condyle has a circular articular facet for the articulation with the head of the
fibula. Distally, the tibia articulates with the fibula and the talus of the foot. Separating the medial and
lateral condyles is the intercondylar eminence, a raised area. The prominent anterior crest forms the “shin.”
The medial malleolus is the projection on the medial side of the distal tibia, the medial bulge of the
“ankle.”
Figure 4-39. The right tibia, posterior view
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HUMAN OSTEOLOGY
Figure 4-40. The right tibia, anterior view
FIBULA
4-83. The fibula is the lateral bone of the lower leg (figures 4-41 and 4-42). The proximal end is called the
head with a projection called the styloid process. The shaft is long and slender with much individual
variation in shape. The distal end of the fibula articulates with the tibia and talus. It forms a triangular
lateral malleolus, the lateral bulge of the ankle.
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Chapter 4
Figure 4-41. The right fibula, dorsal view
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HUMAN OSTEOLOGY
Figure 4-42. The right fibula, medial view
FOOT
4-84. There are 26 bones in each foot (one less than in each hand). The foot bones are categorized as
tarsals, metatarsals, and phalanges (figure 4-43).
Figure 4-43. The right foot, dorsal view
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Chapter 4
Tarsal
4-85. The seven tarsal bones combine with the metatarsals to form the arches (medial arch and anterior
arch) of the foot. The talus is the tarsal bone that articulates with the distal tibia and fibula. The calcaneus
(heel bone) is the largest tarsal bone.
Metatarsals
4-86. The metatarsals are numbered one through five, starting on the “big toe” side with number one and
ending on the “little toe” side with number five. Each is tubular in shape and presents a head, a shaft, and a
base. The head is the rounded distal end. The base is the proximal square-like end.
Phalanges
4-87. Each foot has 14 phalanges (the toe bones). The phalanges of digits two through five are arranged in
three rows—proximal, middle, and distal. The first metatarsal has two phalanges—proximal and distal.
FETAL AND IMMATURE SKELETON

4-88. In the normal operating theater the mortuary affairs specialist may never encounter skeletal fetal
remains. Therefore, a detailed description of such remains is not necessary. There may be, however,
circumstances in which a basic knowledge of fetal remains may be beneficial to case resolution in a field
and/or mortuary setting.
Figure 4-44. The fetal skeleton
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HUMAN OSTEOLOGY
4-89. It is important to remember that fetal skeletal remains are extremely fragile and friable. They are
very small, thin bones that disintegrate easily.
4-90. To the untrained eye, fetal skeletal remains may not even resemble human bone. Because the bones
of the human skeleton develop from a number of separate centers of ossification and growth, the newborn
skeleton includes many bones that are separated into numerous parts. For example, the fetal occipital bone
develops from four parts; the scapula develops from nine parts; and the humerus from eight parts.
4-91. Most of the bones in the skeleton grow through a process of ossification, in which bones are
preceded by cartilage precursors. Ossification of the cartilage starts before birth. During ossification the
cartilage takes on the characteristic shape of the bone and is replaced by bony tissue. The process of
ossification of human bone is complicated. For example, eleven weeks before birth there are approximately
806 centers of bone growth. As the skeleton grows, the centers unite so that by birth there are about 450.
Over the years the process of ossification culminates in the typical 206 bones of the human adult skeleton.
4-92. The typical subadult long bone basically consists of three centers of ossification—termed primary
and secondary centers. The primary center of ossification is the diaphysis (shaft) of the long bone. The
secondary centers are the epiphyses. There is a layer of cartilage between the diaphysis and epiphyses
known as an epiphyseal plate or growth plate. This plate is a cartilaginous center that allows for growth.
Epiphyses are present at each end of the long bones, on the superior and inferior faces of the vertebral
bodies, and in certain other locations where special processes are required for the attachment of muscles.
4-93. In the early stages of ossification, the epiphyses are difficult to distinguish. The epiphyses are
typically rounded, lacking the more mature shape. To an untrained observer they will not be recognized as
human bone. As the epiphyses grow, they begin to take on adult characteristics.
4-94. As the individual matures, the individual bones grow in size and shape and progressively take on the
appearance of the adult bone. Before adolescence, many of the small secondary centers of ossification in
the long bones have fused to the bone, leaving only the proximal and distal epiphyses of the long bones
unfused to the shaft. Before adolescence, the flat bones and the irregular bones have also assumed their
adult shape, leaving only the epiphyses unfused. Later, the epiphyses fuse with the main center to form one
complete bone (figure 4-45).
Figure 4-45. From left to right: fetal femur diaphysis; juvenile femur with appearance of
epiphyses; adolescent femur; subadult femur; subadult femur (note recent fusion of epiphysis
to diaphysis); adult femur
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Chapter 5
DENTAL ANATOMY AND MORPHOLOGY
OBJECTIVE
5-1. To provide the mortuary affairs specialist with knowledge of the human dentition to be able to assist
proficiently in recovering disassociated dental remains.
GLOSSARY OF ODONTOLOGICAL AND ANATOMICAL

TERMINOLOGY
5-2. Odontologists and anthropologists use a specific standardized vocabulary to describe the human
dentition. Standardized terminology facilitates unambiguous communication among all examiners and
researchers.
ALVEOLAR PROCESS
5-3. The alveolar process is the ridge of bone in the maxilla and mandible that contains the alveoli.
ALVEOLUS (SINGULAR), ALVEOLI (PLURAL)

5-4. The alveolus is a single tooth socket; the cavity in which the root of a tooth is held in the alveolar
process.
APEX
5-5. The apex is the terminal or pointed end of the tooth root.
CEMENTUM
5-6. Cementum is the bone-like tissue that covers the root of a tooth.
CROWN
5-7. The crown is that part of the tooth covered by enamel (anatomical). It is the portion of the tooth that
is visible in the mouth (clinical).
CUSP
5-8. A cusp is a conical or cone-shaped elevation on the occlusal surface of the premolars and molars and
on the incisal edge of the canines.
DECIDUOUS DENTITION
5-9. The deciduous dentition are the primary (baby) teeth. They are the first to form, erupt, and function.
There are twenty deciduous teeth. They are shed and replaced by the permanent dentition.
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Chapter 5
DENTIN
5-10. Dentin (or dentine) is the hard tissue that forms the main body of the tooth. It surrounds the pulp
cavity and is covered by enamel in the anatomical crown. Wear of the occlusal surface of a tooth may
expose dentin.
DENTITION
5-11. All the teeth considered collectively in place in the maxilla and mandible.
EDENTULOUS
5-12. Edentulous means without teeth. It may refer to the loss of all the maxillary and/or mandibular teeth.
ENAMEL
5-13. The white mineralized tissue that covers the dentin of the anatomical crown of the tooth.
FORENSIC ODONTOLOGIST
5-14. A forensic odontologist practices forensic odontology. Forensic odontology is a branch of forensic
medicine and, in the interests of justice, deals with a specialized interest in identification and the proper
examination, handling, and presentation of dental evidence in a court of law.
NECK
5-15. The neck is the constricted part of the tooth at the junction of the crown and root.
ODONTOLOGY
5-16. Odontology is the study of the development, formation, and abnormalities of the teeth.
PERMANENT DENTITION
5-17. The permanent dentition are the adult teeth, which are 32 in number.
PULP
5-18. Pulp is the soft tissue that constitutes the central cavity of the tooth. It includes nerves and blood
vessels.
PULP CAVITY
5-19. The pulp cavity is the entire central cavity of a tooth, which contains the pulp.
ROOT
5-20. The root is the part of the tooth that anchors the tooth in the alveolus. It is covered by cementum.
5-2 FM 4-20.65 27 July 2005

Figure 5-1. Tooth anatomy
TOOTH SURFACES
5-21. While the vocabulary for the surfaces of the anterior and posterior teeth is basically the same, there
are some differences.
ANTERIOR
5-22. The anterior teeth (incisors and canines) have four surfaces (mesial, distal, facial, and lingual) and
one edge on their crowns (figure 5-2). As a group, the anterior teeth have single roots and incisal edges or
single-cusped crowns ending in narrow edges designed to incise or bite off relatively large amounts of
food. They are aligned to form a smooth curving arch from the distal surface of the canine on one side of
the arch to the distal surface of the canine on the opposite side.
z Mesial is the surface nearest the midline of the dental arch.
z Distal is the surface farthest from the midline.
z Facial (or labial) is the surface toward the lips (outside). The terms “facial” and “labial” are used
interchangeably. However, the term “facial” will be used in this manual for consistency in
identifying dental remains.
z Lingual is the surface toward the tongue (inside).
Note. Incisal edge or surface is the biting edge of the anterior teeth.
Note. Occlusal surface is the chewing surface of the posterior teeth.
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Chapter 5
Figure 5-2. Tooth surfaces
POSTERIOR
5-23. The posterior teeth (premolars and molars) have five surfaces on their crowns. Posterior teeth differ
from anterior teeth in that they have more than one root, they have multiple cusps forming occlusal
surfaces designed to crush and grind food to small parts, and the part of the dental arch that they form has
little or no curvature.
5-24. Mesial, distal, and lingual are the same surfaces as defined for the anterior teeth.
5-25. Facial (or buccal) is the surface toward the cheeks (corresponds to facial in the anterior teeth). The
terms “facial” and “buccal” are used interchangeably. However, the term “facial” will be used in this
manual for consistency in charting dental remains. When discussing root tips of the posterior teeth, the
term “buccal” is always used.
5-26. Occlusal is the chewing surface and the surface that contacts chewing surface of teeth in the opposite
jaw.
TEETH CLASSIFICATION
5-27. The teeth are arranged in two arches—upper and lower. The upper arch teeth are termed maxillary.
The lower arch teeth are termed mandibular. There is an imaginary vertical line called the midline that
divides each arch into two halves. The halves in each arch are called quadrants. Thus, there are four
quadrants in the mouth—the upper right and upper left (maxillary) and the lower right and lower left
(mandibular).
DECIDUOUS DENTITION
5-28. Each quadrant of the deciduous dentition contains five teeth, for a total of 20 teeth. There are three
types of deciduous teeth—the incisors, canines, and molars (figure 5-3). The number in parentheses
following the tooth name indicates how many of each tooth is represented in each quadrant.
z Incisors (2). The two teeth in each quadrant which are closest to the midline. They are named
central (immediately adjacent to midline) and lateral incisors.
5-4 FM 4-20.65 27 July 2005

z Canine/cuspid (1). The third tooth from midline in each quadrant.

z Molars (2). These first and second molars are the fourth and fifth teeth from midline in each
quadrant.
Figure 5-3. Classification of deciduous dentition
PERMANENT DENTITION
5-29. Each quadrant of the permanent dentition contains eight teeth, for a total of 32 teeth. There are four
types of permanent teeth—the incisors, canines/cuspid, premolars/bicuspids, and molars (figure 5-4). The
number in parentheses following the tooth name indicates how many of each tooth is represented in each
quadrant.
z Incisors (2). The two teeth in each quadrant, which are closest to the midline. They are named
central (immediately adjacent to midline) and lateral incisors. The incisor crowns are flat and
blade-like, as they are designed for cutting and incising.
z Canine/cuspid (1). The third tooth from midline in each quadrant. The tooth is conical with a
pointed cusp. The canines are designed for tearing, piercing, and holding.
z Premolars/biscupids (2). These first and second premolars are the fourth and fifth teeth from
midline in each quadrant. The crowns are round with broad occlusal surfaces. They usually have
two cusps and are also called bicuspids. The premolars are designed for grinding and reducing
food material.
z Molars (3). These first, second, and third molars are the sixth, seventh, and eighth teeth from
midline in each quadrant. The crowns are larger and squarer and have more cusps than the other
teeth. Molars typically have four cusps and multiple roots. The molars are designed for crushing,
grinding, and reducing food material.
Figure 5-4. Classification of the permanent dentition (maxillary)
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Chapter 5
UNIVERSAL NUMBERING SYSTEM

5-30. Each tooth is assigned a number to simplify its designation (figures 5-5 and 5-6). Instead of writing
out the name for the tooth, it is customary to assign a number, letter, or symbol to the tooth in question.
The universal numbering system is the one with the most wide-spread usage and is the system used by the
armed services. It assigns a different number in a consecutive arrangement for all the permanent teeth and a
number-letter to each of the deciduous teeth.
Figure 5-5. Maxillary permanent dentition
Figure 5-6. Mandibular permanent dentition
5-31. For the permanent dentition the numbering begins with the upper right third molar (#1) and
continues around the maxillary arch to the upper left third molar (#16). At this point the succession drops
to the lower left third molar (#17) and continues around the mandibular arch to the lower right third molar,
(#32).
5-32. The 20 deciduous teeth are numbered in the same manner (1-20), but a small (d) is added to the
number as a suffix to designate deciduous. For example, the upper right second molar is #1d, the upper left
second molar is #10d, the lower left second molar is #11d, and the lower right second molar is #20d. (See
figure 5-7.)
5-6 FM 4-20.65 27 July 2005

Figure 5-7. Deciduous dentition
DECIDUOUS DENTITION
5-33. There are three types of deciduous teeth—the incisors, canines/cuspids, and molars. There are no
premolars/bicuspids. The functional role of the deciduous teeth is similar to the function of the permanent
dentition.
5-34. Individual descriptions of the deciduous dentition will not be given. For general considerations, with
the exception of the deciduous first molars, the deciduous teeth are smaller counterparts of the permanent
dentition. The deciduous incisors and canines/cuspids are virtually identical to their permanent
counterparts. The deciduous second molars very closely resemble the permanent first molars.
5-35. The deciduous first molars do not resemble any of the other teeth, deciduous or permanent. They are
the precursors of the permanent premolars. Thus the crowns of the deciduous maxillary and mandibular
first molars do not resemble any other permanent molar crown.
5-36. The crowns of deciduous teeth are lighter in color than the permanent teeth. They exhibit a bluish-
white cast compared to the grayish-white color of the permanent teeth.
PERMANENT DENTITION
MAXILLARY AND MANDIBULAR INCISORS
5-37. The incisors are the two teeth in each quadrant—closest to the midline—on either side of the midline
in the maxilla and mandible. They have single roots and the crowns present a sharp incisal ridge or edge.
The lingual surface is frequently shovel-shaped. The mandibular incisors are smaller then the maxillary
incisors.
5-38. The permanent maxillary central incisors (figure 5-8) are located adjacent to the midline on the
anterior portion of the maxillary dental arch. They are the largest of the incisors. The crowns are greater
than those of the maxillary lateral incisors. The universal numbers are #8 (r) and #9 (l).
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Chapter 5
Figure 5-8. Maxillary right central incisor
5-39. The permanent mandibular central incisors are the smallest and most symmetrical of all the teeth.
The universal numbers are #25 (r) and # 24 (l).
5-40. The permanent maxillary lateral incisors (Figure 5-9) resemble the central incisors but on a smaller
scale. They are smaller in all respects, except root length, which is roughly the same. Maxillary lateral
incisors vary in form more than any other tooth, except the third molar. The universal numbers are #7 (r)
and # 10 (l).
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Figure 5-9. Maxillary right lateral incisor
5-41. The permanent mandibular lateral incisors resemble the mandibular central incisors, except that they
are slightly larger in all dimensions and less symmetrical in outline. The incisal edges are not as straight as
the mandibular central incisors, the distal portion curves toward the lingual. The root lengths are normally
greater than those of the central incisors. The universal numbers are #26 (r) and # 23 (l).
MAXILLARY AND MANDIBULAR CANINES/CUSPIDS

5-42. The canine/cuspid is the longest tooth in the dental arcade and has the largest root in relation to
crown size of any tooth. The canine has a single-pointed cusp. The mandibular canines are smaller in size
than the maxillary canines and also have a narrower crown.
5-43. The permanent maxillary canines/cuspids (Figure 5-10) are the longest teeth in the arch. They are the
only teeth with one cusp. The universal numbers are #6 (r) and #11 (l).
5-44. The permanent mandibular canines/cuspids are similar in many respects to the maxillary canines.
The universal numbers are #27 (r) and # 22 (l).
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Chapter 5
Figure 5-10. Maxillary left canine/cuspid
5-45. The maxillary and mandibular premolars/bicuspids.

5-46. The premolars are also referred to as bicuspids because of the presence of two cusps on the crown.
The maxillary premolars usually have two roots, which may have fused. The mandibular premolars usually
have a single root.
5-47. The permanent maxillary first premolars/bicuspids (figure 5-11) have the longest crowns of the
maxillary premolars. The two maxillary first premolars are more similar to each other than are the
mandibular first premolars. They have two clearly defined cusps (facial and lingual) of approximately
equal size. The universal numbers are #5 (r) and # 12 (l).
5-10 FM 4-20.65 27 July 2005

Figure 5-11. Maxillary left first premolar/bicuspid
5-48. The permanent mandibular first premolars/bicuspids are the smallest of all the premolars. They have
two cusps, but only the facial cusp is functional. This cusp closely resembles the cusp form of the canine.
The mandibular first premolars have a closer resemblance in form and function to the canines than they do
to the mandibular second premolars. These premolars exhibit more variations in form than do their
maxillary counterparts. The universal numbers are #28 (r) and #21 (l).
5-49. The permanent maxillary second premolars/bicuspids closely resemble the maxillary first premolars
with the following exceptions. The crowns are smaller, the cusps are about equal in height, and they have a
single root. In general, the maxillary second premolars are slightly smaller in all dimensions than the
maxillary first premolars. The universal numbers are #4 (r) and #13 (l).
5-50. The permanent mandibular second premolars/bicuspids (figure 5-12) are larger and better developed
than the mandibular first premolars. These teeth assume two common forms in which they may have either
two or three cusps. The three-cusp form probably occurs most often. In this form there is one facial and
two lingual cusps. These premolars exhibit more variations in form than do their maxillary counterparts.
The universal numbers are #29 (r) and #20 (l).
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Chapter 5
Figure 5-12. Maxillary left second premolar/bicuspid
MAXILLARY AND MANDIBULAR MOLARS

5-51. The maxillary molars typically have three roots, while the mandibular molars typically have two
roots which may be fused.
5-52. The permanent maxillary first molars are the largest teeth in the maxilla and have the largest crowns.
They are referred to as the “6-year” molars as, on the average, they erupt at approximately 6 years of age.
The universal numbers are #3 (r) and #14 (l).
5-53. The permanent mandibular first molars (figure 5-13) are the largest and strongest teeth in the
mandible. They normally have five well-developed functional cusps and two well-developed roots. Like
the maxillary first molar, they are referred to as the “6-year” molars as, on the average, they erupt at 6
years of age. The universal numbers are #30 (r) and #19 (l).
Figure 5-13. Mandibular right first molar
5-54. The permanent maxillary second molars closely resemble the maxillary first molars but are generally
smaller. The roots are long and can be longer than those of the maxillary first molars. There may be fusion
5-12 FM 4-20.65 27 July 2005

of the two buccal roots. They are referred to as the “12-year” molars as, on the average, they erupt at 12
years of age. The universal numbers are #2 (r) and # 15 (l).
5-55. The permanent mandibular second molars (figure 5-14) closely resemble the mandibular first molars.
They are, however, smaller in all dimensions and more symmetrical. They normally present four cusps, but
occasionally there may be five. There are two facial and two lingual cusps that are nearly equal in
development. The teeth have two roots that are closer together than those of the mandibular first molars.
Like the maxillary second molars, they are referred to as the “12-year” molars as, on the average, they
erupt at 12 years of age. The universal numbers are #31 (r) and #18 (l).
Figure 5-14. Mandibular left second molar
5-56. The permanent maxillary third molars (wisdom teeth) are the most variable teeth in the upper arch in
form, size, and number of roots. Their most common form closely resembles the maxillary second molars
but smaller in all directions. The crowns show more rounding and the roots are normally shorter than those
of the maxillary second molars. There is a greater chance for fusion of all the roots than in either of the
other maxillary molars. The third molar erupts between 17 and 21 years of age. The universal numbers are
#1 (r) and #16 (l).
Figure 5-15. Mandibular right third molar
5-57. The permanent mandibular third molars (wisdom teeth) are the most variable teeth in the lower arch
in general form, size, crown form, and number of roots. In their most common form, they closely resemble
the maxillary second molars but are smaller in all directions. The crown shows more rounding and the
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Chapter 5
roots are normally shorter than those of the mandibular first and second molars. Single-fused roots are
common as there is a greater chance for fusion of the roots than in either of the other mandibular molars.
The third molar erupts between 17 and 21 years of age. The universal numbers are #32 (r) and #17 (l).
DENTAL CARIES
5-58. Dental cavities (or caries) are an infection caused by a combination of carbohydrate-containing foods
and bacteria that live in the mouth. The bacteria are contained in a film that continuously forms on and
around teeth. This film is called plaque. Although there are many different types of bacteria in the mouth,
only a few are associated with cavities. Some of the most common include Streptococcus mutans,
Lactobacillus casei and acidophilus, and Actinomyces naeslundii. When these bacteria find carbohydrates,
they digest them and produce acid. The exposure to acid causes the PH on the tooth surface to drop. Before
eating, the PH in the mouth is about 6.2 to 7.0, slightly more acidic than water. As "sugary foods" (candy,
sugar frosted breakfast cereals, ice cream, soda, Kool-Aid, and so forth) and other carbohydrates are eaten,
the PH drops. At a PH of 5.2 to 5.5 or below, the acid begins to dissolve the hard enamel that forms the
outer coating of the teeth. Every exposure to these foods allows an acid attack on the teeth for about 20
minutes. As the cavity progresses, it invades the softer dentin directly beneath the enamel and encroaches
on the nerve and blood supply of the tooth contained within the pulp.
5-59. Cavities attack the teeth in two main ways. The first is through the pits and fissures, which are
grooves that are visible on the top biting surfaces of the back teeth (premolars and molars). The pits and
fissures are thin areas of enamel that contain recesses that can trap food and plaque to form a cavity. The
cavity starts from a small point of attack, and spreads widely to invade the underlying dentin. The second
route of acid attack is from a smooth surface, which is between or on the front or back of teeth. In a smooth
surface cavity, the acid must travel through the entire thickness of the enamel. The area of attack is
generally wide and comes to a point or converges as it enters the deeper layers of the tooth.
5-60. The first visible sign of dental decay may be a slightly whitened area in the enamel. This can be
easily overlooked when the enamel is wet but will stand out when it is dry. The caries develops from the
whitened area and varies in size from that of a pinhole to a hole that covers a large percentage of the tooth.
More advanced decay may appear yellowish brown or black.
DENTAL RESTORATIONS
5-61. Dental restorations are broken down into three categories: temporary restorations, permanent
restorations, and prosthetic appliances.
TEMPORARY RESTORATIVE MATERIALS

5-62. Temporary restorative materials are primarily used for emergency and temporary treatment for
permanent teeth and on deciduous teeth. The following materials are used to fill cavities, cement crowns,
and crown (cap) teeth:
z Zinc oxide. Zinc oxide combined with eugenol is used primarily for emergency filling of
advanced caries and fractured enamel and for temporarily cementing crowns and some
appliances. Zinc oxide and eugenol are low in strength and have poor resistance to abrasion.
z Cavit is a clay-like grey material that is most often used as a temporary filling material after root
canal therapy.
z Ketac bond/silver. Ketac bond or silver is white or gray reinforced cements that can be used to
help rebuild a tooth after root canal therapy or as a temporary filling material.
z Stainless steel crown. A stainless steel crown maybe either a dull or shiny gray temporary cap
used on a tooth prepared for a permanent full crown.
5-14 FM 4-20.65 27 July 2005

PERMANENT RESTORATIVE MATERIALS

5-63. Permanent restorative materials are those substances that will last as long as the natural tooth, if not
longer, if proper dental hygiene procedures are followed. Permanent restorative materials are subdivided
into direct and indirect restorative dental materials.
Direct Restorative Dental Materials

5-64. Direct restorative dental materials are those used to directly fill the cavity in the tooth.
z Amalgam. Amalgam is used for dental fillings and sometimes for replacing portions of broken
teeth. Amalgam is a very durable mixture composed mainly of mercury (43-54 percent) and
varying percentages of silver, tin, and copper. A large percent of all permanent restorations are
made of amalgam. This gray filling material is used on the posterior teeth, primarily on the
occlusal surfaces.
z Composite, resin, or white fillings have been around for about 25 years. Composite fillings are
composed of an organic polymer known as bisphenol-A-glycidyl methacrylate (BIS-GMA), and
inorganic particles such as quartz, borosilicate glass, and lithium aluminum silicate. They are
used primarily for esthetic fillings in the front or back teeth.
z Glass ionomers are a mixture of fluoride containing glass powder and organic acid. They form a
solid tooth-colored restoration. They are used for small non-load-bearing fillings, as cements for
crowns and bridges, and as temporary restorations.
z Resin-ionomers are a mixture of submicron glass filler and fluoride containing glass powder and
acrylic resin that forms a solid tooth colored restoration. They are used in small non-load-
bearing fillings, as cements for crowns and bridges, and as liners.
Indirect Restorative Dental Materials

5-65. Indirect restorative dental materials are those that are made by a dental laboratory and used to restore
a tooth. (The composites as described above can be processed and used as indirect restorative dental
materials.)
z Porcelain (ceramic) is a glass-like material formed into fillings and crowns using models of the
prepared teeth. Porcelain can be made to match the color of the tooth being repaired. It is used
for inlays, veneers, crowns, and fixed-bridges.
z Porcelain is often fused to an underlying metal structure to provide strength to a filling, crown,
or fixed bridge.
z Gold alloys are mixtures of gold, copper, and other metals. They are used for onlays, inlays, cast
crowns, and fixed bridges.
z Nickel or cobalt-chrome alloys are mixtures of base metal alloys, such as nickel and chromium,
with a silver appearance. They are used for some crowns, fixed bridges, and partial denture
frameworks.
5-66. Gutta-percha is a widely used pink rubber-like substance used to fill the roots during root canal
therapy. It is easy to manipulate and does not dissolve in oral fluids.
PROSTHETIC APPLIANCES
5-67. Prosthetic appliances are replacements or substitutions for natural teeth.
Denture
5-68. A denture is a removable replacement for missing teeth and adjacent tissues.
5-69. A denture is typically made of acrylic resin, sometimes in combination with various metals. Dentures
constructed more than 30 years ago can also be made from cobalt chromium—a strong, hard metal.
Dentures are constructed using flesh-colored material with natural-looking teeth inserted into the base
material.
27 July 2005 FM 4-20.65 5-15

Chapter 5
5-70. Complete and partial artificial dentures make up the great bulk of dental prosthetic appliances. A
complete denture replaces the entire complement of teeth in an arch. A partial denture is for people who
have some natural teeth remaining or who only need to replace a few teeth. It fills in spaces created by
missing teeth and prevents other teeth from migrating.
Dental Bridge
5-71. A dental bridge is an appliance used to replace one or more missing teeth. There are three types of
bridges.
z A fixed bridge replaces one or more missing teeth. It is made out of a series of joined crowns or
caps that fit into the open place in the mouth, “bridging” the gap. This bridge is made of a pontic
(false) tooth held together by two crowns (a cap that covers the tooth). The bridge is cemented
to the teeth on either side of the gap. The wearer cannot remove a fixed bridge.
z A “Maryland” bridge (resin bonded bridge) is a pontic tooth fused together to metal bands—
bonded to the teeth on either side of the gap with resin cement. This is a common bridge when
teeth are missing from the anterior mouth.
z A cantilever bridge is used in areas that are under less stress. They are most appropriate when
there are teeth on only one side of the open gap.
Dental Implants
5-72. Dental implants are used to replace missing teeth and to prevent bone loss under dentures. They are
titanium rods about one centimeter long that are inserted into the mandible or maxilla. Implants are
substitutes for roots of missing teeth. They serve the same purpose as the tooth roots; they act as anchors.
The implant rods can be threaded, perforated, hollow, solid, coated, or textured.
DENTAL ANOMALIES
5-73. Descriptions of some of the most common abnormalities/variations of the teeth and tooth form will
be addressed.
z Abrasion is the wearing away of tooth structure, typically the occlusal surface, through
mastication (chewing of food), sharp particles, incorrect brushing, or friction of clasps holding a
partial denture.
z Dental fluorosis (mottled enamel) is caused by excessive fluorine intake during the enamel
calcification period. The tooth exhibits chalky white bands or areas, which usually become
pigmented brown or yellow.
z A diastema is a space between teeth that are normally in contact.
z Enamel hypoplasia is a defect in the enamel that occurs during the development of the enamel.
They are grooved bands that can be shallow or deep, and run horizontally across the crown of
the tooth. During the formation of the enamel, the individual suffered some illness that affected
the formation of the enamel.
z Enamel pearls are small, rounded nodules of enamel that are attached to the root surfaces of
teeth.
z Erosion is the chemical wearing away of the tooth structure. It appears on the external surface at
the gum line of the tooth. Where erosion is present, the enamel is usually hard and shiny. In
some cases, the crown may almost be separated from the root.
z Fusion occurs with the union of two adjacent teeth. The teeth are always united through the
enamel and dentin, and occasionally the pulp. The fusion usually involves the crowns only, but
can on occasion involve the crowns and the roots. Fusion is most common in the anterior teeth.
z A tooth fracture is a broken tooth. The enamel, dentin, and pulp are chipped away. A fracture of
the tooth does not have to involve all tooth surfaces. If only the enamel is chipped, it is referred
to as an enamel fracture.
z Macrodontia is used to refer to teeth that are larger in size than normal. The incisors and canines
are most commonly affected.
5-16 FM 4-20.65 27 July 2005

z Malocclusion is any deviation from the normal relationship of the occlusal surfaces of the teeth.
Dental malocclusion is a condition in which the upper and lower jaws do not fit together
normally, either because they are not the right size or because the teeth are not aligned correctly.
This can be due to genetics, from trauma to the face or jaw, or from dysfunction of the
temporomandibular joint.
z Microdontia is used to refer to teeth that are smaller in size than normal. The maxillary lateral
incisors and maxillary third molars are most commonly affected.
z Migration/drift is when one or more teeth move or drift into a space not occupied by a tooth.
The absent tooth was either extracted or erupted in an unusual manner.
z Rotation may be present in any of the teeth, but it is more common in the anterior teeth. A
rotated tooth is one that is twisted in such a way that one or more of its surfaces are not in their
proper location.
z Supernumerary (extra) teeth are an excessive number of teeth. The term “accessory” is
frequently used as the “extra” teeth usually do not resemble normal teeth in size or shape.
27 July 2005 FM 4-20.65 5-17

Chapter 6
BASIC MEDICOLEGAL DEATH INVESTIGATION
OBJECTIVE
6-1. This chapter serves as a rudimentary outline on basic medicolegal death investigation. The intent of
this chapter is not to make the mortuary affairs specialist a proficient medicolegal death investigator.
However, this chapter will provide the mortuary affairs specialist with the knowledge of medical, legal,
and scientific standards to ensure that all crucial forensic evidence is preserved and documented in
compliance with MDI standards during the 92M mission of search, recovery, evacuation, and tentative
identification of remains.
INTRODUCTION
6-2. To complete a death investigation successfully requires an individual with training in a variety of
disciplines. The term “medicolegal investigation of death” incorporates both medical and legal knowledge.
Since death is often a natural medical event that demands an understanding of human anatomy, physiology,
and disease processes, the need for medical knowledge is obvious. Likewise, as some deaths may involve
the commission of a crime or other unnatural events, it is also essential to have an understanding of
jurisdictional laws and the legal aspects of a case. In addition, the medicolegal death investigator must have
knowledge of criminalistics and public health issues.
6-3. At a typical death scene, the local law enforcement agency is responsible for the overall scene. The
medicolegal death investigator responds to a death scene to assume the responsibility for the body and to
conduct an investigation to help establish the cause and manner of death. Proper investigation at the death
scene, with follow-through investigations, will ensure that significant information concerning the death
will be documented. Medicolegal death investigators must have the requisite medical knowledge,
knowledge of the legal aspects of the job, and the proper techniques for interrelating with family, friends,
police, and other individuals whom the investigator may contact in the course of an investigation.
6-4. Medical legal investigations in the United States (primarily unnatural or suspected unnatural deaths)
are carried out by medical examiner or coroner systems. The current trend is for medical examiner systems
to replace the coroner system. However, there are still a significant number of coroner systems in operation
in the United States.
6-5. The coroner system is the older of the two medicolegal systems. Coroners have been around for
centuries, dating back to when there were no forensic pathologists, and autopsies were virtually unheard of.
A coroner is an elected official who may or may not be a physician (anyone could become a coroner).
Training required for a corner varies from none to a few hours to one to two weeks. The coroner
investigates by inquest any death not due to natural causes. The coroner will make the decision as to cause
and manner of death. The coroner will determine if an autopsy should be conducted and will have a
pathologist conduct the autopsy. Since the coroner or his administrative designee signs the death
certificates, it follows that in a coroner system the doctor who completes the autopsy in most cases will not
be the one to sign the death certificate.
6-6. The medical examiner system was first introduced in the United States in Boston, Massachusetts in
1877. Medical examiners—usually physicians and generally with training in pathology, medicolegal death
investigation, and performance of forensic autopsies—generally have greater expertise in unnatural death
investigations than do coroners. The major advantages of a statewide medical examiner system are the
quality of death investigations and forensic pathology services and their independence from population
27 July 2005 FM 4-20.65 6-1

Chapter 6
size, county budget variation, and politics. Certification of death is done by highly trained medical
professionals who can integrate autopsy findings with those from the death scene and the laboratory. These
professionals have core competency in assessing immediate and earlier medical history and physical
examination.
ROLE OF THE MEDICOLEGAL DEATH INVESTIGATOR

6-7. The medicolegal death investigator is typically a representative of the medical examiner’s/coroner’s
office. He is the eyes and ears of the medical examiner, with jurisdiction over all evidence from the body.
The death investigator should be better trained and more knowledgeable of the causes of death than other
investigators at the scene. He must know medical terminology, abbreviations, medicine in a clinical setting,
prescribed prescriptions, and various medical procedures.
6-8. The death investigator focuses on the physical condition of the body at the scene. The death
investigator gathers detailed preliminary information at the scene concerning injuries, trace evidence,
identification, estimation of time of death, cause of death, and manner of death. This information is
invaluable to other forensic scientists, including the medical examiner and investigators and criminalists
from law enforcement agencies.
6-9. The death investigator will conduct an investigation when a death is violent, suspicious, occurs in
custody, or occurs at the work place. Many jurisdictions require an investigation in all infant/child deaths
and in nonviolent deaths in individuals less than 30 years of age.
6-10. The death investigator will request medical records, review the records, thin the records to pertinent
files only, and then copy the records.
6-11. The death investigator will meet with families, interview witnesses, and write a narrative report of
his findings concerning the death incident.
ARRIVE AT THE DEATH SCENE
Introduce Yourself
6-12. When the investigator arrives at the death scene, he must take the initiative to introduce himself. This
introduction serves to establish formal contact with other official agency representatives, helps to identify
the lead investigator/team leader and first responder to the scene, and helps to establish a common
investigative effort. The investigator will then work with other key personnel to ensure scene safety before
entering the death scene.
Establish Scene Safety

6-13. Scene safety is essential to the investigative process. Safety can be comprised by a variety of factors,
including hostile crowds, dangerous terrain, collapsing structures, traffic, or chemical and biological
hazards. It may be that these particular hazards actually caused the death. The investigator must be alert to
these conditions and establish scene safety before entering the scene. Appropriate emergency personnel
may need to be contacted to control hazardous conditions. In these instances, scene processing must be
delayed until the area has been declared safe.
Confirm Death
6-14. The standard operating procedure for confirming death varies from jurisdiction to jurisdiction. The
appropriate individual—be it physician, medical examiner, coroner, nurse, or paramedic—must make the
determination of death or evidence of death before the death investigation begins. The investigator must,
therefore, ensure that the authorized individual has viewed the body and made an official pronouncement
of death. After the death has been determined, the medicolegal jurisdiction can be established.
6-15. The investigator must document the name and title of the individual who pronounced the death and
the official time, date, and location of death. These items are an essential component of the investigation.
6-2 FM 4-20.65 27 July 2005

Communicate with Responding Agency/Agencies

6-16. As numerous agencies respond to a typical death scene, information is dispersed among various
individuals, such as police officials, crime laboratory personnel, and emergency personnel. The death
investigator must recognize the various responsibilities of these agencies and receive and share information
accordingly.
6-17. The death investigator must identify specific responsibilities, share appropriate preliminary
information, and establish the investigative goals of each agency present at the scene. A scene briefing will
ensure the initial factual exchange of information as it is known at the time. (A crime scene is not static,
information and situations change as time goes on.) This information includes scene location, time factors,
initial witness information, agency responsibilities, and investigative strategy. The scene briefing will also
serve to ensure that each participant is familiar with each other’s role and responsibility.
6-18. The death investigator must cooperate with other investigators, law enforcement officials, and other
specialists at the scene. Each involved individual has legal responsibilities—conflicts can arise if these
responsibilities are not understood by all parties before the investigation begins.
6-19. The death investigator has the legal authority to request information from outside agencies. The
correct procedures must be followed to request this information. Typically the investigator makes a formal
request in writing to the appropriate agency.
6-20. The death investigator will also share information with outside agencies. This is typically
information that has been compiled by the medical examiner/coroner. The investigator may share this
information as long as the requesting agency has a legal right to the information.
6-21. The death investigator must maintain confidentiality. He may not release information received from
an outside agency to a third party. This information is not the investigator’s (or his office’s) right to
release. The requesting third party must request the information directly from the original office.
Conduct a Scene Walk-Through

6-22. The preliminary walk-through is necessary to minimize scene disturbance, identify potential
evidence, and prevent the loss and/or contamination of that evidence. The walk-through will provide the
investigator with an overview of the entire scene, the first opportunity to locate and view the body and
identify fragile evidence, an opportunity to determine the time interval between the death incident and the
time the medical examiner’s office was notified, and formulate an investigative plan for a systematic
examination and documentation of the scene and the body.
Initiate Chain Of Custody

6-23. Establishing and maintaining a chain of custody over evidence ensures the integrity of the evidence
and reduces the likelihood of a challenge to that integrity. A court will require proof that evidence collected
during an investigation and that being submitted to the court are one and the same. Chain of custody is
initiated with the marking of physical evidence at the time of collection. Chain of custody is a witnessed,
written record of all the individuals who had contact with and/or maintained control over items of
evidence. It is documentation of possession that serves as a list of individuals who had custody of the
evidence, the date(s) of transfer, and where the evidence was secured while in custody. The chain of
custody provides integrity, accountability, and unbroken control over the evidence, and ensures that the
evidence has not been tampered with or substituted. It establishes proof that the items of evidence collected
at the scene are the same items presented in a court of law.
6-24. The death investigator must know which agency is responsible for the collection and custodianship
of specific types of evidence. The medical examiner/coroner is routinely responsible for the body and
associated evidence. The death scene and associated evidence is the jurisdiction of the local law
enforcement agency.
6-25. The law varies from state to state, so it is essential that the death investigator is knowledgeable about
his jurisdiction’s statutes. The investigator must work with other responding agencies to determine the
27 July 2005 FM 4-20.65 6-3

Chapter 6
applicable laws regarding evidence collection. The investigator must follow local, state, and federal laws
for evidence collection to ensure that it will be admissible in a court of law.
6-26. The evidence is placed into a container at the scene and labeled or tagged. Information pertaining to
the case—such as the name or initials of the collector; the date the item was collected and transferred; the
agency, case number, and type of crime; and a brief description of the item—is written on the label or tag.
6-27. The U.S. Army uses DA Form 4137 to maintain chain of custody (refer to Appendix B). Any
individual who initiates a chain of custody and signs the objects over to the appropriate authority should
retain a copy of the form.
DOCUMENT AND EVALUATE THE DEATH SCENE
Photograph the Death Scene

6-28. Usually a representative of the responding law enforcement agency will photograph the entire death
scene. The death investigator should take photographs for the forensic pathologist/medical examiner
performing the autopsy. Photographs must be available for other investigators and agencies to recreate the
death scene.
6-29. The photographic documentation of the death scene establishes a permanent record of the scene.
Photographs in conjunction with the written documentation, sketches, and witness statements will provide
adequate documentation of the body and the scene.
6-30. Photographs are a permanent visual record of the scene and associated evidence. They depict a
sequence, from general to specific, of a death scene. Therefore, photographs should be taken of the overall
scene, of midrange views to show the relationships of evidence, and close-ups of each item of evidence.
Typically two close-up photographs of each object will be taken, one with a scale or ruler and one without.
Additional close-up photographs will be taken as needed. The progressive nature of the photographs allows
for orientation of the scene as a whole and the orientation of evidence and objects within the scene.
Evidence photographs provide for examination of specific items of evidence, particularly transient items,
and may be substituted for laboratory examination.
6-31. Ensure that an adequate amount of photographs are taken. Photographs should be detailed and, like a
written narrative, tell the story of the death scene.
6-32. Photographs should be taken as soon as possible, typically immediately following the preliminary
scene survey. Thoroughly photograph the death scene before it has been examined and before the body and
any objects have been moved. If an item has been compromised prior to documentation, do not move the
object to “stage” it the way it would have looked at the time of the crime.
6-33. Prepare a scene placard with the date, time, location, agency, case number, and investigator.
Photograph the placard.
6-34. A photographic log, a complete written record of all photographic documentation at the scene, must
be kept.
6-35. Photograph the scene and the body from different angles to provide various perspectives that may
aid in any future analyses. Take general, overall photographs of the scene to provide a spatial orientation of
the scene to the surrounding area. Take midrange photographs of the relationship of objects to one another.
Proceed to detailed photographs of the body, to include the face, and of specific injuries and areas of the
scene.
6-36. The investigator should take photographs with a scale to document specific evidence. Identical
photographs should be taken without the scale.
6-37. The investigator should take photographs even if the body or other evidence was moved. If evidence
and/or the body was moved prior to photographing, it should be noted in the written report. Never
reintroduce the evidence and/or body into the scene.
6-4 FM 4-20.65 27 July 2005

Provide Written Documentation of the Death Scene

6-38. Everything a death scene investigator learns during the investigation should be documented. Written
documentation of the death scene provides a permanent record that, in correlation with photographs and
sketches, will enable authorities with a legitimate interest to recreate the scene. Effective notes attempt to
answer the who, what, when, where, why, and how of the investigation. Notes should be taken in
chronological order and should not be edited. They should be detailed—documenting step by step all
actions. Notes should be as specific as possible, complete, and thorough. They should provide a running
narrative of the conditions at the death scene. Notes should describe the scene as it appears and record
transient evidence (odors, sights, sounds) and weather conditions. The location and description of potential
physical evidence and objects should be recorded before anything is moved. Notes do not include opinions,
analysis, or conclusions. They include only the facts. Rough notes, as well as sketches, should never be
discarded but included in the case file.
6-39. In addition to filling out all required office forms, the investigator should write a narrative report
concerning the circumstances of the death and the individual’s medical history. This report should be
written in chronological order and in a form that can be easily understood by forensic professionals as well
as laymen. It is not unusual for the family of the decedent to request a copy of the investigator’s report.
6-40. The investigator should ask who, what, where, when, how, and why to answer key death
investigation questions. Gathering this information can take weeks, even months. These answers form the
body of the narrative report. Each report must be accurate, thorough, unbiased, and clearly written
immediately after the investigation. When writing the narrative, the death investigator should use
terminology such as, “in accordance with the records at hand” or “according to such and such an
individual.” This terminology makes it clear that the investigator is passing on information as he received
it. Outside agencies often depend on information from the death investigator to complete their analyses.
The investigator’s report must, therefore, be written in a timely fashion.
6-41. Sketches are drawings that accurately depict the appearance of a death scene. The sketch is a
permanent record of the scene. It documents objects present and the position, size, and relationship of the
objects to one another. It must portray the most essential elements of the death scene and their relationship
to the scene.
6-42. A rough sketch is drawn at the scene and is used as a model for the finished sketch. The rough
sketch is usually made before evidence collection. It shows all the evidence to be collected and all relevant
structures. Rough sketches are not normally drawn to scale. However, measurements of objects and
between objects must be taken during sketching for a drawn-to-scale diagram, if necessary.
6-43. The final sketch is prepared from the rough sketch and is usually prepared for courtroom
presentation. The final sketch presents a clean, uncluttered appearance.
6-44. The sketch should include the agency case number, incident type, name of the sketcher, date, time,
location, weather and lighting conditions, reference points, a key or legend, north orientation, and a scale.
6-45. Sketches are used to supplement photographs. They have an advantage over photographs in that they
can cover a large area and can be drawn to leave out much of the clutter that appears in photographs. A
sketch will also provide a better representation of spatial relationships of objects to each other than does a
photograph.
6-46. There are three useful methods for completing a sketch—floor plan, exploded, and triangulation. The
type of sketch chosen is not especially important. What is important is that the sketch best depicts the death
scene and most easily illustrates the event to the viewer.
Floor Plan
6-47. The floor plan is the most common and simplest method (figure 6-1). It provides an overhead (bird’s
eye) view of the scene detailing locations where evidence is found. It may be used in nearly all crime scene
situations where items of interest are located in one plane.
27 July 2005 FM 4-20.65 6-5

Chapter 6
Figure 6-1. Floor plan method
Exploded View
6-48. The exploded view or cross-projection method (figure 6-2) is similar to the floor plan—except the
walls have been folded down into the same plane as the floor. This allows for documentation of evidence
found on/in the walls.
Figure 6-2. Exploded/cross-projection method
Triangulation Method
6-49. The triangulation method (figure 6-3) is particularly useful for outdoor scenes. Evidence is measured
from two separate points of reference to locate and position the evidence within the diagram.
6-6 FM 4-20.65 27 July 2005

Figure 6-3. Triangulation method
6-50. All documentation will be compiled into a case file. Forensic and/or technical reports shall be added
to the file when they become available.
Evaluate Probable Location of Injury or Illness

6-51. The precise location where the decedent is found within the scene is important (as is the geographic
location of the scene) and must be documented. Scene sketches are used to depict the exact location of the
body. Measure as accurately as possible from fixed points within the scene and describe the orientation of
the body—such as head to east, feet to west.
6-52. As the environment where the decedent was discovered affects the body’s postmortem changes, it is
important to document the environmental conditions at the location. Observe the environment and
associated evidence at the death scene. These observations will include a variety of factors/situations. The
investigator should record such conditions as temperature, airflow, moisture, lighting, unusual conditions,
and the type of surface the body was resting upon.
6-53. The location where the body was found may not be the actual location where the injury or illness that
caused/contributed to the death took place. The death investigator must make a concerted effort to
determine the location of any and all injuries or illnesses. Physical evidence at these locations may be
relevant in establishing the cause, manner, and circumstances of death.
z If the body was moved after death, the investigator must make every attempt to determine the
location from where the body was moved and how it was moved.
z In livor mortis the color, location, and blanchability should be consistent with the position of the
body as discovered. In rigor mortis the stage, intensity, and location of the body should be
consistent with the position of the body as discovered. The death investigator should identify
and document any discrepancies.
z The investigator should check the body, clothing, and scene for inconsistencies of trace
evidence and document the location of this evidence.
z The investigator should check for drag marks and any post-injury activity.
z The investigator should correlate the information obtained from the body with information
derived from the scene to provide a reliable evaluation of the scene and the death incident.
27 July 2005 FM 4-20.65 6-7

Chapter 6
Collect and Safeguard Physical Evidence and Personal Property

6-54. As part of the investigation, the responsible individual will ensure that all personal effects and
physical evidence are collected, inventoried, safeguarded, and released as required by law. The distinction
between personal effects and physical evidence should be made. Physical evidence can be any object that
the investigator feels is pertinent in explaining the circumstances of the crime. Personal effects may or may
not be physical evidence. Personal effects are property on or near the body, which belongs to the decedent
and can be returned to the family/next of kin. The appropriate authority must distinguish between personal
property and physical evidence. The decedent’s personal property must be safeguarded to ensure proper
processing and return to the next of kin. Physical evidence on or near the body must be safeguarded to
ensure chain of custody and its availability for further evaluation by forensic specialists.
6-55. The investigator must ensure that all items, personal property, and/or physical evidence are removed
prior to the closure of the scene and relinquishment by officials. After a scene is turned over, it will require
a search warrant to reenter the scene. Additionally, once law enforcement personnel have left the scene, the
investigator may not return and confiscate items without the permission of the owner.
6-56. One of the most (if not the most) important factor in a death scene investigation is the handling of
evidence. Most of the clues that lead to the solution of a crime are at the scene in the form of physical
evidence. Physical evidence is any material item at a crime scene that would prove that a crime was
committed, that could link a suspect to a scene or victim, that could establish the identity of a victim or
suspect, and/or establish key elements of a crime. Physical evidence collected from a scene is the
cornerstone upon which successful case resolution depends. The death scene investigator must be
proficient in recognizing, collecting, preserving, packaging, and processing physical evidence.
Physical Evidence
6-57. All physical evidence on the body should remain in its original position—to the maximum extent
possible—and be protected while the body is transported to the morgue. Frequently there is evidence on
the body that may not be visible to the naked eye. Trace evidence is very small—often microscopic—
physical evidence that can be discovered on a body. Trace evidence is difficult to recognize, locate, and
collect. Although microscopic, trace evidence is often a significant part of an investigation. It is often
helpful in placing a suspect at a scene or in contact with a particular item or individual. Clothing is an
excellent source of trace evidence. Footwear, the victim’s body, the suspect’s body, tools used as weapons,
tools used in burglaries, and a vehicle used in a hit-and-run are additional examples. The variety of types of
trace evidence is almost endless. Some examples include fibers, textiles, hair, blood, glass, soil, paint,
metals, rope, cigarettes, tobacco, burned paper, ash, vegetation, foodstuffs, cosmetics, tape, and electrical
wires.
6-58. When an individual comes into contact with a person or location, exchanges of trace evidence will
often occur. Locard’s Principle of Exchange states that anytime someone enters a crime/death scene, they
either bring something in or take something out with them. The importance of exchange/transfer of
evidence is that it links suspects to victims or locations. The linkage of trace evidence is directional in that
it is equally important to find physical evidence from the suspect on the victim and evidence from the
victim on the suspect.
6-59. The appropriate authority will collect any physical evidence that is related to the death and make it
available to the medical examiner. Any item that is on or attached to the decedent is under the control of
the medicolegal death investigator. Any item at the death scene that is not on or attached to the decedent is
under the control of the law enforcement agency.
6-60. The appropriate collection and packaging for different types of physical evidence is very important.
Improperly collected and/or packaged evidence can be compromised or even obliterated before it reaches
the laboratory. Therefore, it is strongly recommended that only trained criminalists or crime scene evidence
specialists collect, mark, preserve, and package evidence. The following general guidelines are offered.
z Secure physical evidence in suitable containers so that the evidence can be preserved and
transferred safely.
6-8 FM 4-20.65 27 July 2005

z Place each item of evidence in a separate container.

z Seal all evidence containers with evidence tape at the scene at the time of collection. (The
evidence tape should completely cover any openings of the container and be marked with the
collector’s initials and date and time of collection. The marks should extend over the edge of the
evidence tape onto the package itself.)
6-61. A variety of packaging materials, sealing tape, and assorted evidence collection materials are
commercially available. Different types of evidence require different packaging.
z Most evidence can be collected in paper containers, such as bags, envelopes, packets, and boxes.
z Liquids can be stored in nonbreakable, leak-proof containers.
z New, unused, lined paint cans or glass jars with screw-cap lids, are used for arson evidence or
other volatile materials.
z Small items (such as hair and fibers) should be folded up in a sheet of paper
(pharmaceutical/druggist fold) and then placed in an envelope. Alternately, they can be placed in
a glassine bag.
z Wet evidence of a biological nature (such as blood) should be allowed to air dry before
packaging. If this is not possible, wet evidence of a biological nature should be packaged and
permitted to air dry as soon as possible.
z Plastic can be used in a judicious and timely fashion—although plastic can draw moisture and
permit the growth of microorganisms, which can destroy or alter evidence. (Refer to appendix
C.)
Personal Property
6-62. Describe jewelry as to style, type, color, and location on the body. All descriptions of jewelry should
be generic, not specific. For example, never describe a ring as gold with a diamond; describe it as yellow
metal with a clear stone.. This process should always be conducted in the presence of a witness. Do not
remove jewelry from the body.
6-63. Count money and list the amount using the denominations of currency present following
jurisdictional protocols. Note credit card details.
6-64. Examine personal papers to determine if they contain identification information or notes of intent of
self-harm or suicide.
6-65. The appropriate authority should confiscate all illicit drugs and paraphernalia; prescription, over the
counter, and homeopathic medications; and alcoholic beverage containers, when appropriate. These items
will be conveyed to a toxologist and will be vital in determining what, if any, contribution these items
made to the death. The investigator should note the location of these items as there is a strong likelihood
that the fatal item will be found in the same room as the decedent.
6-66. Ensure that the property form/chain of custody includes the date and case number and is signed by
both the investigator and witness. Seal the personal property in a bag or envelope and release it to the
proper authorities.
Interview Witness(es) at the Death Scene

6-67. Jurisdictional policies dictate who should be interviewed at a death scene and by whom. The
investigator must be knowledgeable about these procedures and act accordingly.
6-68. Interviews should include basic information such as the decedent’s identification; time, date, and
physical condition when last seen alive; time, date, and location of the discovery of the body; the individual
who discovered the body; medical, social, and employment history; and any other events that may have a
bearing on the death.
6-69. If possible, the investigator will collect the following information from every witness interviewed:
z All available identifying data (full name, address, date of birth, work and home phone numbers).
27 July 2005 FM 4-20.65 6-9

Chapter 6
z The relationship/association, if any, of the witness to the decedent.

z The basis of the witness’ knowledge (how does the witness have knowledge of the death?). The
investigator will note any discrepancies between the witness’ statement and the appearance of
the scene and any discrepancies between witnesses’ statements.
6-70. When conducting an interview, the investigator should be assertive without being aggressive. He
must have control of the situation. Provide guidance and structure to the interview (especially when dealing
with distraught family members). Be aware of body language and present a neat appearance. Maintain eye
contact, exude confidence, and speak slowly. A medicolegal death investigator is a good listener.
6-71. Whenever possible avoid technical terms. Explain investigative and medical procedures in words
that are easily understood by the layperson. When providing notification of death, avoid expressions that
may be misunderstood or lead to confusion and misinterpretation. Terms such as “expired,” “passed away,”
“bit the dust,” should never be used. There is no confusion/substitution for the words “death,” “died,” or
“deceased.”
DOCUMENT THE BODY
Photograph the Body

6-72. Photographic documentation of the body at the scene creates a permanent record of body position,
identity, final movements, and appearance. Photographs are irreplaceable for studying the death scene later,
will assist in proving or disproving the consistency of the defendant’s story, and may be submitted as
evidence. The investigator should obtain both instant and permanent high-quality photographs of the body.
6-73. The body should be photographed as it was initially discovered, before either it or associated
physical evidence is moved. Photograph both the body and the immediate scene. Take photographs that
depict the relationship of the victim to physical evidence.
6-74. The decedent’s face should be photographed. The face, and the rest of the body, should never be
cleaned for a photograph. Take multiple shots if necessary.
6-75. Take at least two photographs of the body at 90-degree angles to each other. Take overall and close-
up photographs of the body from four directions.
6-76. Take close-up photographs of all wounds, injuries, and/or marks observed on the body at both an
intermediate and close-up distance. Photograph any physical evidence or items that have potential to be
physical evidence. Take as many photographs as needed to adequately document the body. Photograph the
decedent with and without a scale.
6-77. Take additional photographs after items that interfere with the photographic documentation have
been removed. An example of this would be the removal of a body from a vehicle.
6-78. Photograph the opposite side of the body after it has been turned over (after the external
examination). Photograph the surface beneath the body only after the body has been removed.
Conduct a Superficial External Body Assessment

6-79. After the body has been photographed, conduct a thorough and systematic external assessment of the
body at the scene. The death investigator’s main responsibility is to determine as much as possible about
the death from the decedent at the scene. The external assessment provides the death investigator with
objective data on the most single important piece of evidence at the death scene—the body. The assessment
provides details concerning the decedent’s physical attributes, relationship to the scene, and possible cause
and manner of death.
6-80. The external assessment does not include any analyses on the body at the death scene—do not take
fingerprints, do not collect trace evidence/residue, do not remove clothing, do not clean the body, and do
not place anything on the body that might interfere with future examinations.
6-10 FM 4-20.65 27 July 2005

6-81. Assess the body in a methodical fashion—begin at the top of the decedent’s head and progress
downward, concentrating equally on all portions of the body. It is better to begin the assessment without
turning the body over. If the decedent is lying on his/her back, examine the front of the body first and vice
versa. Place a clean white sheet next to the body and lift the body onto the sheet when the other side of the
body is to be inspected. The sheet prevents contamination and/or loss of evidence.
6-82. When the examination is complete, the sheet will serve to encase the body. Both ends of the sheet
are secured/knotted before placement in a human remains pouch.
6-83. The hands, feet, and head, when necessary, should be placed in paper bags and secured with a rubber
band.
6-84. Each body should have an identification tag securely attached before transport to the morgue.
6-85. Document the decedent’s position (for example, supine or prone)—this may help establish if the
body was moved before discovery. Describe the location where the body was found—this may have a
bearing on trace evidence on and around the body. Document the direction of the body (for example, head
to the west and feet to the east). Document the temperature of the remains. The investigator can use either a
gloved hand to touch the body or use a liver probe.
6-86. Document the environment in which the decedent was found, as the environment has a definite
impact on the rate of decomposition. Note temperature, wind, precipitation, moisture, and the surface on
which the body was resting. If present, note the state of decomposition and insects on the body.
6-87. The death investigator should document a full description of the decedent. Describe the demographic
profile of the decedent—include sex; approximate age (or date of birth, if known); approximate height
(note if measured or estimated); approximate weight (note if weighed or estimated); hair color, length, and
style; eye color (contacts or eye glasses); clothing; jewelry; tattoos; scars; and state of nutrition, cleanliness
and dental care.
6-88. To the extent possible, given the death scene conditions, document the clothing worn by the
decedent. Describe all items worn (color, fabric, type), their state of cleanliness, their position,
appropriateness of size, appropriateness in manner worn, and appropriateness for the weather and location.
If the clothing is inappropriate for the weather and location where the decedent was found, the
discrepancies must be explained. Describe if the clothing is consistent with normal dressing techniques.
Note if any portion of the clothing is out of place. Document the location of any cuts, tears, or defects in
the clothing as they may be consistent with trauma to the body.
6-89. Document the presence or absence of injury, trauma, abnormalities, unnatural-appearing marks,
scars, and/or tattoos to the body. Document the presence of medical treatment or resuscitative efforts.
6-90. After the body is moved, carefully inspect beneath the body for additional evidence/information.
Document Cause, Manner, and Time of Death

6-91. Documentation of postmortem changes is essential to determine an accurate cause and manner of
death, provide information on the time of death, corroborate witness statements, and determine if the body
was moved before law enforcement personnel arrived.
6-92. There are numerous methods that, when used in conjunction, will provide for an estimation of time
of death. Use a combination of all available evidence. Weigh the evidence and be suspicious when some
factors seem to deviate considerably from the others.
6-93. It is important to assess the state of rigor mortis and specify the time and place of the assessment.
State if rigor mortis is not present or just beginning, if the extremities bend with some difficulty, if the
extremities bend with much difficulty, or if the extremities will not bend.
6-94. Describe the presence or absence of livor mortis, its location on the body, and its color. If livor
mortis is cherry red in color, it can indicate cause of death (carbon monoxide or cyanide poisoning or
hypothermia).
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Chapter 6
6-95. Body temperature (algor mortis) can be measured using scientific measuring equipment, such as a
telethermometer. If no such equipment is available, then the investigator can touch (wearing gloves) an
uncovered portion of the body and determine if the temperature is hot, warm, cool, or cold.
6-96. If the body stays at the scene for more than one hour after the initial assessments have been made,
then a second set of assessments (rigor mortis, livor mortis, and body temperature) should be made.
6-97. Document the stage of decomposition, insect activity, and plants around the body, if present.
6-98. To aid in estimating time of death, determine when the individual was last seen alive and by whom.
Document the remarks, name, address, phone number, and relationship of the individual who last spoke
with or saw the individual alive. Document the remarks, name, address, phone number, and relationship of
the individual who discovered the body. Also focus on why the individual found the body.
6-99. As possible, document the decedent’s daily activities and ordinary habits. Question friends, relatives,
and neighbors to discern if the decedent engaged in any unusual activities shortly before death, what was
the decedent’s usual waking, sleeping, and eating habits. Answers to these questions may help narrow the
time of death.
6-100. The death scene investigator should note—
z If there is uncollected mail or dated items (such as a newspaper or a sales receipt).
z If the alarm clock is set.
z If food is in the refrigerator and/or on the stove and what the condition is of the food (fresh,
outdated, spoiled).
z What was the last meal consumed.
z If animals are in the house, what is their condition.
6-101. The death scene investigator must gather information that relates to the cause and manner of death.
The type of death will dictate the information that the investigator will need to document. The questions
that an investigator should ask in a drowning are different than those in the case of a self-inflicted gunshot
wound.
6-102. Any blood splatter/patterns found on or near the decedent should be photographed, both with and
without a measuring device, before the body is moved. Splatter and flow patterns should be consistent with
gravity. Discrepancies should be noted and analyzed.
6-103. Any items or substances that may have caused or contributed to the death should be noted,
photographed, and collected by the proper individual.
6-104. The results of the superficial external examination of the body may yield information regarding
the cause and/or manner of death. The death scene investigator should note any marks of violence (stab
wound, gunshot wounds), ligature marks, or physical restraints. Are defense wounds present, indicating
that the decedent put up a struggle? The death investigator should be able to recognize the effects of
different types of trauma to a body that may allow him to establish the cause and manner of death. (For
details, refer to chapter 3.)
Preserve Evidence on the Body

6-105. Photographic and written documentation of evidence on the body establishes a permanent record
of the evidence. To maintain chain of custody, the death investigator must collect, package, preserve, and
transport evidence properly. In addition to physical evidence present on the body, body fluids (such as
blood) must be photographed and documented prior to collection and transport. Remember that any item
that is on or attached to the body belongs with the body and therefore to the medical examiner/coroner.
6-106. Photograph the evidence that is associated with the body.
6-107. In addition to proper collection, packaging, preservation, and transport of evidence, the death
investigator should know the potential examinations that can be conducted on evidence. Evidence may
include insect casings, maggots, body fluids, cartridge casings, pill containers, weapons, and so forth. The
6-12 FM 4-20.65 27 July 2005

death scene investigator should be able to recognize the various types of analyses that are performed on
evidence and where the analyses can be done.
6-108. The death investigator should document all body fluids (froth, purge, or other substances) as to
location and pattern before the body/samples are transported.
6-109. Typically the physical evidence, clothing, personal effects, and equipment on a body should
remain in its original position and be protected when the body is transported to the morgue. However,
ammunition and firearms and other potentially dangerous items, such as a syringe, do not remain with the
body. In some rare instances, the investigator may collect trace evidence (blood, hair, fibers) before
transport of the body to the medical examiner. He should be knowledgeable of jurisdiction procedures for
evidence collection.
6-110. Place the decedent’s hands, feet, and head, if necessary, in clean paper bags and secure the bags
with rubber bands. When such precautions have been taken to preserve evidence, they should be
documented in writing.
Ensure the Security of the Remains

6-111. Ensuring the security of the remains facilitates proper identification of the remains, maintains
chain of custody of the remains and associated evidence, and safeguards personal property.
6-112. The autopsy is conducted by the forensic pathologist to document all injuries that are on the body
at the time of the examination. It is essential that the death investigator assures that the body reaches the
medical examiner in the same condition as it left the scene. Prior to the body leaving the scene, the death
scene investigator must ensure that the body is protected from postmortem trauma, tampering, and/or
contamination.
6-113. The death investigator may be a part of the labeling, packaging, removal, and transfer/transport of
the remains. Place an identification tag on the body to prevent misidentification upon receipt at the medical
examiner’s/coroner’s office. This function also serves to protect all potential physical (trace) evidence
and/or property and clothing on the body.
6-114. Place the body in a clean, secured white sheet. The death scene investigator should then supervise
the placement of the decedent into a human remains pouch.
6-115. The responsibility for custody of the body varies from jurisdiction to jurisdiction. The proper
authority should be familiar with all individuals who will be in contact with the body from the time it
leaves the scene until it reaches the medical examiner’s office. If any problems arise regarding the
respectful and careful handling of the decedent, these issues should be immediately addressed and
resolved.
Participate in the Scene Debriefing

6-116. A scene debriefing is the best opportunity for all participants to communicate special requests,
share data regarding particular scene findings, and establish clear lines of responsibility.
6-117. The scene debriefing helps all investigators establish postscene responsibilities. Responsibilities
include, but are not limited to, the individual responsible for the identification of the decedent, the
individual who will notify the next of kin, the individual responsible for media relations, and the individual
responsible for evidence transportation.
6-118. During the debriefing, participating investigators can communicate the need for assistance from
outside agencies and additional specialists—such as, social services, anthropologists, crime laboratory
technicians, and so forth.
6-119. Confidentiality must be maintained when using additional outside agencies.
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Chapter 6
ESTABLISH AND RECORD THE DECEDENT’S PROFILE/DEMOGRAPHIC INFORMATION TO

FACILITATE IDENTIFICATION
Document the Discovery History

6-120. The death investigator, or other responsible authority, must establish a decedent’s profile which
will, in turn, facilitate subsequent investigations of the case. The death investigator must document the
individual(s) who discovered the body, where it was discovered, and when. The investigator should record
why/how that particular individual(s) discovered the body and the circumstances surrounding the
discovery.
Determine Terminal Episode Information

6-121. Any contributing factors that may have played a significant role in determining cause and manner
of death should be documented to assist the medical examiner/coroner in his examination of the body.
(Refer to chapter 7.)
6-122. The death investigator should document when, where, how, and by whom the decedent was last
seen alive.
6-123. The death investigator should document the incidents prior to death, including any resuscitative
attempts.
Document the Decedent’s Medical History

6-124. In both sudden/unexpected deaths and natural deaths a detailed medical history may aid in
determining cause and manner of death. In natural deaths, the thorough medical history helps to focus the
medical examiner’s investigation.
6-125. The decedent’s medical history determines the need for a postmortem examination and/or
additional laboratory tests. The relationship between disease and injury may play a role in the cause and
manner of death. Medical history helps to exclude other causes and manners of death and may be such that
an autopsy is not needed.
6-126. The death investigator should contact the decedent’s medical provider(s) to obtain medical
records. The investigator should ask the physician questions concerning any previous illness, therapy, or
diagnoses. The investigator should document the decedent’s medical history, including medications taken,
and a family medical history from family members.
6-127. The death investigator should request medical records from hospitals or medical treatment
facilities, if necessary, to confirm the decedent’s medical history and treatment.
Document the Decedent’s Mental Health History

6-128. If necessary, a detailed psychiatric history should be obtained. The decedent’s mental health
history may provide insight into the behavior/state of mind of the individual during the time preceding
death. This information, in turn, may aid in establishing the cause, manner and circumstances of death.
6-129. The death investigator should document the following:
z Decedent’s mental health history, including hospitalizations and treatment by mental health
professionals.
z The family mental health history.
z Any history of suicidal tendencies, gestures, or attempts.
6-14 FM 4-20.65 27 July 2005

Document the Decedent’s Social History

6-130. The death investigator, or other authority, should gather information from sources familiar with
the decedent concerning the decedent’s social history. This information may help determine the cause,
manner, and circumstances of death.
6-131. The death investigator should document the following:
z Marital/domestic history, domestic abuse, and family history concerning similar deaths and
significant dates.
z Relationships, friends, associates, and sexual history.
z History of smoking, amount of alcohol consumption, and/or use of illegal or therapeutic drugs.
z Employment, financial, and criminal history.
z Educational background.
z Daily routines, habits, and activities.
Establish the Decedent’s Identification

6-132. Positive identification of the decedent allows for notification of next to kin, grief resolution for
survivors, settlement of estates and insurance claims, resolution of criminal and civil litigation, disposition
of the remains, basic human dignity and respect, and completion of the death certificate. The state of
human identification falls into one of three categories—unidentified, presumptive, or positive.
Unidentified
6-133. Unfortunately, despite exhaustive efforts by forensic experts there are some remains that may
never be identified. These cases are frequently where individuals are unknown, decomposed, mutilated,
skeletonized, or incinerated. Victims of mass casualties and military operations may also be difficult to
identify. Unidentified individuals should be described as to the location where found.
Presumptive
6-134. Presumptive identifications are typically made on skeletal remains—clothing, personal effects,
circumstances surrounding the death, radiographs, and physical features. An individual who is a
presumptive identification should not be designated as a John Doe, Jane Doe, or Baby Doe. The individual
should be designated as BTB.
Note. Skeletal remains should be examined by a forensic anthropologist. (Refer to chapter 9 for
details.)
6-135. Presumptive identification (from clothing and portable personal property found on or near the
body) and circumstantial identification (from the location found, such as residence, work place, or vehicle)
is perilous and should be avoided. Personal property is portable and can easily be added to or removed
from the decedent. A presumptive identification may, however, be made at times (depending on the
circumstances in which remains were discovered). For example, virtually incomplete human remains are
discovered in a residence completely destroyed by fire. The occupant of the home was last seen in the
home and there is no reason to believe that anyone else was present in the house. Therefore, a presumptive
identification can be made based on a probability of circumstance or circumstances.
6-136. A comparison of antemortem and postmortem radiographs is frequently used as a means to
establish identification. The concurrence between the radiographs does not always ensure a positive
identification. A presumptive identification can be made if the radiographs are consistent and all other
possible individuals have been eliminated from the identification process.
6-137. Physical features, such as birth marks, tattoos, scars, surgical procedures, and other physical
anomalies are useful in establishing a presumptive identification. Depending on the particular case, the
27 July 2005 FM 4-20.65 6-15

Chapter 6
presence or absence of such features will help establish a possible identification or eliminate possible
individuals from the identification process.
6-138. Although visual identification is the most common and easiest method of identification, it is the
least reliable. It is a subjective means of identification, it is not scientific, and problems may arise. Injuries,
burns, mutilation, and decomposition can lead to extensive disfigurement and make a visual identification
impossible. Many people bear a close resemblance to one another. Family members may be in a highly
emotional state, in shock, or denial. In some cases, the identifier may have something to gain from a
misidentification of the body, such as insurance fraud or covering up a murder.
Positive
6-139. Positive identifications are based upon scientific methods, such as fingerprint comparison, dental,
DNA, radiographs, and/or autopsy findings compared with antemortem medical records. (Refer to chapter
8 for details.)
MAINTAIN ETHICAL AND LEGAL RESPONSIBILITIES
Maintain the Dignity of the Decedent

6-140. The decedent’s body must be treated with dignity, reverence, and respect. The decedent’s rights
must be protected. The decedent has a name, family, and friends. Morgue humor can be a destructive force
in the life of the death investigator—it is inappropriate, distasteful, and if excessive requires disciplinary
action. Inappropriate gestures, touches, and statements must not be tolerated. The death investigator has a
professional responsibility to maintain the dignity of the deceased.
Safeguard Personal Property Against Theft

6-141. Items found on the body at the time of death will eventually be returned to the decedent’s next of
kin. Every item on the decedent should be identified as the death investigator will not be able to understand
its significance to a family member. An item that may appear to be of no monetary value may, in actuality,
be of great sentimental value to a family member.
Project a Positive/Professional Image

6-142. The death investigator should take professional responsibility for every death reported to him. The
death investigator is accountable to his office and the community for the work he performs. The death
investigator must maintain and project a positive, professional image in all interactions with outside
organizations and the decedent’s family. The death investigator should never judge a family’s reaction to
death as cultural, social, and ethnic backgrounds will affect their behavior. Volatile and unpredictable
situations can develop at a death scene or during interviews with witnesses and family members. The
investigator must remain focused and complete the investigation free of prejudices and bias.
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Chapter 7
EXAMINATION OF FLESHED REMAINS
OBJECTIVE
7-1. To provide the mortuary affairs specialist with the knowledge to proficiently process DD Form 890
and anatomical charts and to assist with autopsies of fleshed remains.
SCOPE OF THE AUTOPSY

7-2. An autopsy is a postmortem medical examination of a dead body to determine the cause of death.
The word “autopsy” is derived from the Greek word “autopsia,” meaning to see for oneself. The autopsy is
a series of tests and examinations performed on a body to identify an injury and/or disease that may have
caused or contributed to the death. The autopsy provides a permanent legal record of the gross and minute
anatomical peculiarities of the individual’s health and cause of death. There are two types of autopsies.
PRIVATE AUTOPSY
7-3. A private autopsy is conducted after legal next-of-kin requests in various circumstances. These
situations include, but are not limited to, sudden death, unexpected death, questions concerning patient
care, questions concerning the cause of death, alleged malpractice, and refusal of the hospital to conduct an
autopsy. Medical autopsies in hospitals require the consent by the next of kin. Hospital autopsies, as a rule,
stress internal examinations and are usually satisfied with cursory external examinations.
FORENSIC AUTOPSY
7-4. The forensic autopsy is a connection between law and medicine and can be performed without the
permission of the next of kin for legal reasons. The results of the autopsy furnish the forensic pathologist
with the evidence on which to base a medicolegal opinion.
7-5. The forensic autopsy is performed to establish the circumstances preceding and surrounding a death,
to determine the cause and manner of death, and to approximate the time of death. Physical evidence will
be identified, collected, and preserved. Information gained from the forensic autopsy will be provided to
law enforcement agencies, families, attorneys, news media, and others with a need to know.
7-6. The forensic autopsy is performed—
z In deaths due to violence.
z Deaths that are sudden, unexpected, or unexplained.
z Deaths occurring in custody.
z Deaths occurring in unusual places or under suspicious circumstances.
z Deaths involving the possibility of neglect.
z Deaths in which no physician will certify the death as natural.
z Deaths in the workplace.
z To assist in reconstruction of the fatal injury.
z To assist law enforcement agencies in the prosecution of a crime and/or identification of a
victim.
z To assist in matters of public health.
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Chapter 7
AUTOPSY PROCEDURES
7-7. DA Form 2773, DD Form 890, and an anatomical chart will be prepared.
7-8. A forensic autopsy involves both an internal and an external examination, as well as examination of
all available information regarding the medical history of the decedent, the circumstances surrounding
death, and the scene investigation. The forensic autopsy may include toxicology, chemistry, and/or
microscopic examination of tissues and fluids. Forensic autopsies place a higher degree of emphasis on the
external examination than do medical/private autopsies. This fact is related to the legal aspect of the
forensic autopsy and the expertise of the forensic pathologist, who is trained to recognize patterns of
injury, collect physical evidence, and investigate the circumstances surrounding the death. The autopsy
report typically includes written documentation, body diagrams documenting injuries and identifying
characteristics, and photographs.
EXTERNAL EXAMINATION
7-9. The external examination is a detailed examination of the external surface of the body, from head to
toe. It begins before removal of the clothing.
z Examine clothing for the presence of tears consistent with wounds on the body, blood, other
body fluids, and foreign/trace evidence.
z Document general body/identification characteristics, including, but not limited to, racial group;
sex; height; weight; state of nourishment; body build; appearance of the ears, eyes, nose, and
mouth; hair color and length; and eye color.
z Document more specific identifying characteristics such as prosthesis, pacemaker, scars, moles,
tattoos, skin lesions, needle tracks, or other markings that may aid in identifying the body.
z Document any significant disabling antemortem conditions (amputations, abnormalities,
deformities disfigurements, loss of eye, and so forth) and/or diseases.
z Document postmortem changes—namely, algor mortis, rigor mortis (extent and degree), livor
mortis (distribution, dual pattern, color, contact pallor), and putrefactive (decompositional)
change.
z Describe and take inventory of clothing, jewelry, valuables, personal effects, and physical
evidence.
z Document specific injuries either by grouping them according to anatomical location or in
numerical order. In cases of multiple injuries, the numbering sequence does not imply the order
in which the injuries were inflicted or degree of severity. Injuries are described by type
(abrasion, laceration, stab wound and so forth), location, size, shape, pattern, and color.
z Describe evidence for medical intervention. This includes all medical equipment attached to, or
accompanying, the body—such as, a urinary catheter or intravenous lines. External surgical
incisions are described in continuity with the internal evidence of surgery.
z Depending on the nature of the death, collect certain biological and trace evidence. The forensic
pathologist, or trace evidence analyst under the pathologist’s supervision, collects trace
evidence—such as glass, hairs, and fibers—from the clothing and body for examination by other
forensic specialists. Biological evidence—such as semen, saliva, tears, and perspiration—can be
collected from the external body.
z Take fingerprints, palm prints, footprints, or any combination thereof.
z Take photographs.
Note. If deemed necessary, X-rays will be taken to document injuries or to aid in the
identification process. If antemortem X-rays exist, then the forensic pathologist may take X-rays
during autopsy for comparison of features as a means of identification. X-rays are also used to
locate bullets, foreign metallic fragments, and metal appliances from surgical procedures.
7-2 FM 4-20.65 27 July 2005

INTERNAL EXAMINATION
7-10. The internal examination is a systematic dissection of the body and the removal of internal organs
for observation. The pathologist—
z Exams every body organ and records the results. He provides a gross description of body organs
to include weight, appearance, and any abnormalities observed.
z Describes diseases, chronic or previously unknown,
z Describes internal injuries in connection with related external injuries. The internal
trajectory/course of injuries is charted.
z Records negative observations (observations that there are no injuries or abnormalities of the
organs). A statement that a certain finding is not present can be as important as a positive
finding. These statements are included in the autopsy report to verify that a certain part of the
anatomy was, indeed, examined.
z Collects biological specimens (an essential part of every forensic autopsy). Biological samples,
tissue samples for histology slides, and toxicology specimens are typically taken. The Armed
Forces Institute of Pathology recommends taking the following samples during autopsy: blood
(up to 100 milliliter); urine (100 milliliter); bile (all available); vitreous (all available); liver (100
grams); brain (100 to 200 grams); kidney (50 grams); lung (50 grams); and gastric (50 grams).
Whole tissue, cells obtained from tissue, blood, organs, eye fluid, gastric contents, and body
fluids are sources of biological samples. Biological samples may be taken for a number of
reasons including, but not limited to, DNA testing, determination of alcohol content,
presence of drugs, and presence of disease. Specimens are also taken for toxicological
analysis. Toxicology analysis provides tests and analysis of the role that drugs and toxic
agents played in the cause and manner of death.
Histology is the study of the minute structure of tissues, basically at the cellular level. The
tissue samples taken by the pathologist are frozen, cut in a chamber, mounted on a slide,
and stained for immediate review. Or samples may be fixed, paraffin embedded, cut and
stained for later review. The paraffin embedded tissue is stable for many years of storage.
This process provides a view of the tissue at the cellular level to help the pathologist
diagnose cause of death.
z Takes photographs.
CAUSE, MANNER, AND MECHANISM OF DEATH

7-11. Two of the most important functions of the forensic pathologist are the determination of cause and
manner of death. The forensic pathologist—using autopsy findings, laboratory tests, and the facts
concerning the circumstances leading up to the death—forms an educated opinion on the cause and manner
of death.
Cause of Death
7-12. The cause of death is the forensic pathologist’s medical opinion concerning any injury or disease that
started the events that lead to the death. It is the specific reason that a person dies. Several examples of
cause of death are: gunshot wound, stab wound, heart disease, AIDS, drug overdose, strangulation, and
hanging.
Manner of Death
7-13. The manner of death explains how the cause of death came about. Manner of death is basically a
medicolegal opinion made by the forensic pathologist based on the individual’s history, the circumstances
of death, autopsy findings, and any substantiated investigative information. Manner of death is generally
listed as natural (absence of hostile environment/caused by disease), homicide (someone else caused the
victim’s death), suicide (the victim caused his/her own death intentionally), accident (presence of a hostile
environment/caused by violent means), or undetermined. While homicide is a neutral term, suicide requires
evidence of intent.
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Chapter 7
Mechanism of Death
7-14. Mechanism of death is the physiologic reason for an individual’s death. It is produced by the cause
of death. For example, an individual is discovered hanging (cause), dies of asphyxia (mechanism), and the
death is ruled a suicide (manner). Or an individual is shot in the abdomen (cause), dies of massive internal
hemorrhaging (mechanism), and the death is ruled a homicide (manner).
TIME OF DEATH
7-15. The forensic pathologist will attempt to determine time of death. Determining time of death is based
on eyewitness accounts and changes in the appearance and characteristics of the body after death.
Determining the interval between the time of death and the time the body is found can be difficult. The
exact time of death cannot be determined, unless witnessed. All the methods used to determine the time of
death are not precise; instead, they usually give relative indicators. They are estimations. As the amount of
time between death and the attempt to determine the time of death increases, the estimate is less precise and
there is a greater chance for error. There are numerous individual observations when used together will
provide the best estimate of the time of death. These are rigor mortis, livor mortis, algor mortis,
decompositional changes, and stomach contents. Environmental conditions and the physical characteristics
of an individual must also be considered as they impact and affect these observations.
Rigor Mortis
7-16. Rigor mortis is the stiffening of the muscles after death due to chemical changes in the muscle fibers.
Muscular relaxation immediately after death is followed by the onset of rigidity and shortening of the
muscle. All muscles of the body begin to stiffen at the same time and the same rate. However, different
muscles appear to stiffen at different rates because of their size. The small muscles of the cheek, jaw, face,
hands, and feet appear to stiffen first followed by a gradual spread to the large muscle groups. A body is
said to be in full rigor when the jaw, elbow, and knee joints are immovable.
7-17. Rigor mortis usually appears 2 to 4 hours after death, peaks between 6 and 12 hours, and disappears
between 12 and 36 hours. Rigor mortis passes as muscle decomposition begins, usually between 24 and 36
hours. As rigor disappears, the muscles will begin to loosen in the same order they appeared to stiffen.
7-18. Body temperature, physical activity before death, cocaine, amphetamines, and the environment
where the body was found will affect the onset of rigor mortis. For example, the higher the body
temperature, the sooner rigor occurs. Rigor develops more quickly if an individual was involved in
strenuous physical activity just before death. Rigor is accelerated in warmer environments and slowed in
cooler environments.
7-19. When a body stiffens, it will stay in position until rigor passes or if rigor is physically broken. If
rigor is broken by manipulation of a particular joint, it does not reappear in the same area. Rigor mortis is
typically less set in the old and young.
7-20. Rigor mortis does not “defy” gravity. If the arms and legs of a body are raised above the surface into
the air, the body has been moved after rigor had begun.
Livor Mortis
7-21. Livor mortis is the reddish-violet discoloration of the body after death. It is caused by the settling of
the blood in vessels, through gravity, in the dependent areas of the body (such as on the back of an
individual lying supine). Some dependent areas will not discolor because the bones will compress the skin
against a hard surface and prevent the settling of blood. These areas will appear pale in contrast. For
example, if a body is on its back, the area below the elbows, scapulae, and buttocks will be pale. This is
called “contact pallor.”
7-22. Livor mortis is noticeable approximately 1 to 2 hours after death and develops gradually until it
becomes fixed between 8 and 12 hours. Turning the body cannot displace livor once livor has fixed. Livor
mortis will be visible until the body becomes completely discolored by decomposition.
7-4 FM 4-20.65 27 July 2005

7-23. Livor mortis is important in determining if a body has been moved after death. If a body is
discovered face down and there is livor mortis on the back, then at the time of death the body was on its
back. If a body is moved after partial development of livor, a dual pattern, called shifting, may result.
7-24. The color of livor mortis may provide an indication relating to cause of death. A cherry red color
suggests carbon monoxide or cyanide poisoning or hypothermia. A green-brown color suggests drugs or
poisons affecting hemoglobin formation in the blood. A dark blue discoloration suggests asphyxia.
Algor Mortis
7-25. Algor mortis is the cooling of the body after death to the ambient (surrounding) temperature. Some
physicians use body temperatures to determine time since death. The most reliable readings are obtained
from the liver and rectum. The reading is entered into a formula to calculate time since death.
7-26. The temperature of the body may rise 1.0 to 1.5 degrees in the first few hours after death, and then
begin to fall. The body starts to cool approximately 2.0 to 2.5 degrees Fahrenheit per hour in the first 6
hours after death. Between 6 and 12 hours, the body cools at approximately 1.5 to 2.0 degrees Fahrenheit
per hour. Between 12 and 30 hours, the body cools at approximately 1.0 to 1.5 degrees Fahrenheit per
hour.
7-27. There are numerous variables that affect algor mortis. These include environmental conditions and
temperature, illness, body fat, body surface area (infants cool more quickly), the surface the body was lying
on, the amount of clothing worn, air currents, and body temperature at time of death. The determination of
time since death by algor mortis depends on two assumptions that may not be true.
z The first assumption is that the body temperature at the time of death was the normal 98.6
degrees. Level of physical activity, drug and alcohol use, exposure to cold, and shock are some
examples of factors that can affect normal body temperature.
z The second assumption is that a body cools at a constant, uniform rate. Many factors affect the
rate at which a body loses heat.
Decomposition
7-28. Decomposition (putrefaction) is the sequence of physicochemical events that begins with death. It
results from cell destruction and the actions of internal and/or external bacteria. Bacteria from the intestinal
tract and wounds enter the blood vessels and tissue through the walls of the intestines and from the external
environment.
7-29. Rates of decomposition depend on a variety of factors including, but not limited to, temperature,
humidity, precipitation, soil composition, insect activity, presence or absence of clothing, body weight and
size, and where the body was discovered. A generally accepted approximation for degree of decomposition
is that one week in air is equivalent to two weeks in water and eight weeks in soil. Thus, a body on the
ground surface will decay before a body in the water. A body in water will decay before a body buried in
soil. Rates of decomposition are not precise and differ in different parts of the country. The following is a
general picture of decomposition.
z As rigor passes, the skin turns greenish in the right lower abdomen (24 hours) and then spreads
through the rest of the abdomen (24 to 36 hours).
z The face will swell/bloat and marbling will appear (36 to 48 hours). Marbling is a greenish-
black coloration along the vessels.
z The body will go through general bloating from the gas formed by the bacteria. The body is now
a pale green to green-black color. Increased internal temperature caused by bacterial gas
production forces body fluids out of body orifices, a process called purging (60 to 72 hours).
Typically decomposition occurs more rapidly in areas of injuries.
z Between four and seven days localized collections of fluids appear in the epidermis (skin blebs).
There is hair sloughing and skin slippage. Over days and weeks, body tissues dehydrate and
skeletonization occurs.
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Chapter 7
z After complete skeletonization, the bones will slowly weather and break down. This process can
last decades or centuries. The effects of weathering include bleaching, exfoliation of the cortical
bone, and demineralization. As with fleshed remains, the rate and severity of these
decompositional changes are affected by environmental conditions.
z Alternatives to decomposition include mummification and adipocere formation. In
mummification, the body dries out faster than decomposition takes place. Mummification
typically occurs in hot, dry environments. In adipocere formation, the tissues are transformed
into a wax-like substance that acts as a preservative. Adipocere forms in the absence of free
oxygen and in a wet, cool environment, such as a water burial (a drowning victim, for example),
an airtight but moist crypt, or a moist grave.
Stomach Contents
7-30. The volume and type of food present in the stomach at autopsy may be used to identify the
composition of “the last meal” and estimating the time interval between eating and death. Estimating time
since death based on stomach volume is, however, very imprecise. For example, a body discovered in the
late afternoon with breakfast type food in the stomach would suggest that death occurred in the morning. A
variety of factors affect this estimation of time since death. These include, but are not limited to, weight of
the meal, liquid content of the food, caloric content, amount of chewing, and composition of the food. In
general, however, a light meal is digested in 1 to 2 hours and a heavy meal takes between approximately 4
and 6 hours. The intestine usually empties between 10 and 12 hours after the last meal.
7-31. Environmental conditions at the scene can help experts determine the time since death.
Entomological and botanical data together may narrow the time of death to weeks or months.
7-32. Medicolegal forensic entomology is the branch of entomology that focuses on legal investigations.
Medicolegal forensic entomology uses insects that inhabit decomposing remains to aid criminal/legal
investigations. The identification of insects collected from or near corpses depends on a fully qualified
forensic entomologist. Typically a forensic entomologist is consulted in a death investigation to provide an
estimation of PMI, to help determine if the body was moved after death, and/or to help determine if the
body was disturbed at some time. However, the primary application of forensic entomology is to determine
the PMI, which can be accomplished in one of two ways. The method used is dictated by the circumstances
of each case.
7-33. When the PMI is from one month and up to a year or more, then the forensic entomologist analyzes
the successive wave of insects that are present on the remains. Each stage of decomposition attracts
different species of insects. Some insects are, however, involved in each stage of decomposition. The first
group of insects to arrive on a corpse is the family Calliphoridae—the blowflies. Blowflies, the metallic
green or blue flies, can arrive within a few minutes of death in the presence of blood or other body fluids.
Other insects, not attracted to fresh remains, arrive later. Some insects arrive to feed on other insects
already inhabiting the remains. There is an overlap in the arrival time (succession) of insects that are
present on the remains. The different species of insects present on the remains at a given time combined
with a knowledge of the local insect population and rates of arrival and development allows the forensic
entomologist to determine an estimation of the PMI. The estimation will always be a range of time, not an
exact time of death. Knowledge of the succession of insects can also be used to indicate the season of
death, such as late summer.
7-34. When the PMI is less than a month, then the forensic entomologist will analyze maggot age and
development. If the entomologist knows how long after death the eggs are laid, and how fast the larva
grows, then he can estimate the length of time that the corpse was exposed to insects (PMI). This method
can provide a PMI of a day or less if used within the first few weeks of death. The most important insects
on the corpse are the family, Calliphoridae—the blowflies. There are four life/developmental stages for the
family Calliphoridae—egg, larva, puparium, and adult (figure 7-1). Each of these developmental stages
takes a set, known time based on temperature. The insect will develop faster at warmer temperatures.
7-6 FM 4-20.65 27 July 2005

Figure 7-1. The life cycle of the blowfly
7-35. When the female blowfly arrives at a corpse, she lays clumps of white, sausage-shaped eggs. The
eggs are typically laid in the natural orifices—such as the mouth, ears, and nasal openings; and in wounds
and bruises.
7-36. After a set period of time, the eggs hatch into a first stage larva, commonly known as maggots. The
maggots are white and cone-shaped and grow by eating the corpse. As they grow, they will move from the
area in which they were laid to other areas, such as beneath the corpse and along the edges. These larvae
molt into the puparium.
7-37. The puparium (plural, puparia) continues to feed for a while until it stops to find a safe place to
pupate. During this time, the living insect is inside its hardened outer skin. This outer shell, pupal case,
protects the insect as it metamorphoses into an adult. While inside the pupal case, the insect cannot eat or
move. The freshly formed pupae are pale in color but darken to a deep brown in several hours. The puparia
are frequently overlooked at crime scenes as they are usually not found on the corpse, but rather in the
vicinity of the corpse. They are frequently found in the folds of clothing and may also be found up to 30
feet from the corpse.
7-38. After a number of days, an adult fly will emerge from the pupa. The newly-emerged fly does not fly
much as its body hardens. At first the fly is pale in color and soft with crumpled wings. The wings expand
later and the fly turns blue or green.
7-39. The forensic entomologist can also help to determine if the body was moved after death. Insect
species vary by location and can be very particular about the type of environment they inhabit and where
they feed or lay eggs. For example, some insects prefer shade, some prefer sun, some inhabit rural areas,
and others prefer urban environments. Some insect species are unique to specific geographic regions.
Therefore, if the insect species recovered from a corpse at a given location are not native to the location,
but rather are from a different location, then it is obvious that the body was moved after death. This
information will also provide the legal authorities with an indication of the type of area where the death
actually occurred.
7-40. Lastly, maggots can be tested by the forensic pathologist to determine the presence of chemicals in
remains. When the maggots feed on a body, they digest any chemicals present in the body. Testing
maggots can provide information on suspected poisoning and drug overdose cases.
7-41. Forensic botanists also play an important role in criminal cases. Occasionally vegetation is associated
with the remains or site being investigated. Forensic botanists can determine if a body has been moved
from its original resting place and can link plant matter from the scene with that found upon the victim
and/or the victim’s personal effects. They can also determine the time of year a particular specimen would
normally be present, its growth stage, and how much time elapsed since the body was found. Very often,
27 July 2005 FM 4-20.65 7-7

Chapter 7
trace botanical evidence can link an object or suspect to the scene of a crime, as well as rule out a suspect
or support an alibi. The forensic botanist relies on the facts that plants can be identified through
microscopic characteristics—such as seeds, pollens, and spores—and that many plants grow exclusively in
particular areas.
7-42. Photographic documentation of the autopsy may be taken before, during, and after the autopsy. The
body should be photographed before anything is moved, removed, or added to the body. The sequence of
photographs should tell the story of the autopsy and proceed logically from one to the other. Typically a
photograph of the full-length view of the body is taken. Another standard shot in forensic autopsy
photography is the full-face (identification) view. This photograph is taken to establish the identity of the
body. Close-up views of injuries, wounds, and organs may be taken.
BIOLOGICAL SPECIMENS
7-43. During a forensic autopsy, the forensic pathologist, or a forensic autopsy technician, will draw
various biological specimens for further analysis. Collecting biological specimens is an essential part of
every forensic autopsy. Whole tissue, cells obtained from tissue, blood, organs, eye fluid, gastric contents,
and body fluids are sources of biological samples. Biological samples may be taken for a number of
reasons including, but not limited to, DNA testing, determination of alcohol content, presence of drugs, and
presence of disease. Specimens are also taken for toxicological analysis. Toxicology analysis provides tests
and analysis of the role that drugs and toxic agents played in the cause and manner of death.
7-44. The type and amount of biological specimens collected at a forensic autopsy will vary among the
different medical examiner’s systems across the country. The following presents one example of samples
drawn and the method by which they are collected.
7-45. Four biological samples are drawn from each decedent.
z Draw up to 10 cubic centimeters of vitreous fluid using an 18-gauge needle.
z Draw up to 10 cubic centimeters of bile using an 18-gauge needle.
z Draw up to 10 cubic centimeters of urine using an 18-gauge needle.
z Draw up to 60 cubic centimeters of blood using a 13-gauge needle.
7-46. Blood is drawn in the following preferred order: iliac artery, subclavian artery, heart. If no other
blood is available, purge fluid is drawn from the plural cavity of decomposed remains.
7-47. Samples are placed in the appropriate vacutainers.
7-48. Used needles are placed in a sharps container.
7-49. Separate stock jars are prepared for each representative tissue sample collected from the pathologist.
Samples are secured in the stock jars and the jars are initialed.
z Stock jars are filled with 10 percent buffered formalin phosphate solution.
z Stock jars are labeled with the following information when the name of the decedent is known:
case number, date, jurisdiction, pathologist, name of the decedent.
z Stock jars are labeled with the following information when the name of the decedent is
unknown: case number, date, jurisdiction, pathologist, “unidentified,” race, and sex.
7-50. The brain is fixed for future analysis.
z A plastic bucket is filled 2/3 full with 20 percent buffered formalin phosphate solution.
z The brain is secured in cheese cloth.
z The brain is suspended in the bucket by securing the cheese cloth onto the bucket handles.
z The lid is secured on the bucket.
z The bucket is labeled with the following information when the name of the decedent is known:
case number, date, jurisdiction, pathologist, name of the decedent.
z The bucket is labeled with the following information when the name of the decedent is
unknown: case number, date, jurisdiction, pathologist, “unidentified,” race, and sex.
7-8 FM 4-20.65 27 July 2005

Chapter 8
PRIMARY IDENTIFICATION OF REMAINS
OBJECTIVE
8-1. This chapter will provide the mortuary affairs specialist with the basic knowledge of the three
primary methods of identifying human remains. In most cases, these are the only scientific means of a
positive identification. These methods are dental identification, fingerprints, and DNA profiling (analysis).
Footprints are not typically used in the civilian sector as a means of identification. They are, however, used
by the U.S. Air Force as means of positive identification. Thus, footprinting will also be covered.
DENTAL IDENTIFICATION
8-2. Forensic odontology is the study of dentistry as it pertains to the law. It is the branch of forensic
medicine that applies dental knowledge to civil and criminal matters. The military expands this definition
to include the unique needs of the military services. Dental identification is a definitive means of positive
identification of unknown remains. Because teeth are the hardest and most mineralized part of the human
body, they tend to survive postmortem events and intervals relatively intact. Whereas soft tissue will not
survive immersion in water, decomposition, skeletonization, or mummification, the teeth will. Teeth are
relatively resistant to fire. It takes temperatures of over 1,000 degrees Fahrenheit to destroy the teeth. Even
in these cases the roots, enclosed in dense alveolar bone, tend to be protected and can be used for
identification. In addition, gold alloys, porcelain prostheses, and silver amalgams will withstand
temperatures up to 1,600 degrees Fahrenheit.
8-3. It is recommended that the dental remains be processed/charted on a dental chart before viewing any
antemortem dental records that may exist. This practice prevents any bias, in looking for certain features,
on the behalf of the recorder. Completing a dental chart is relatively straightforward—but tedious.
Attention to detail is a must as the form depicts an exact record of the decedent’s dentition. Before
initiation of a dental chart and upon release from the medical examiner, if necessary, gently clean the
dental remains with tap water and a soft toothbrush. (Burnt teeth are brittle and will shatter if not treated
carefully.)
z The universal tooth numbering system as described in chapter 5 is typically used on dental
charts.
z A dental chart should illustrate, as graphically as possible, the following:
Location (tooth and tooth surface), shape, and size of restorations.
Materials used in the restorations.
Prostheses, implants, and pins present.
Teeth present (including supernumerary teeth) or absent (antemortem versus postmortem
tooth loss).
Unerupted/impacted teeth.
Anomalies.
Caries, fractures, pathologies, attrition, and abrasions.
Tooth position (occlusal relationships, misaligned teeth, rotations, diastemas and other
occlusal discrepancies).
8-4. Each individual has a potential of having 32 teeth. Each tooth has five different tooth surfaces
(incisal/occlusal, distal, medial, facial, and lingual). Thus, there is a potential of 160 surfaces to chart on a
dental chart. When the numerous combinations of teeth (absent, present, restored or not restored), tooth
27 July 2005 FM 4-20.65 8-1

Chapter 8
surfaces, and types of restorative dental materials are taken into account, the probability of establishing a
dental identification is extremely high. When additional factors—such as pathologies, anomalies,
extractions, root form, and dental prostheses—are taken into account, then a unique dental identification
can typically be established.
8-5. A dental identification may be made solely on the number of teeth present. It is important, therefore,
to determine if any missing teeth were lost postmortem or antemortem.
8-6. Basically, the distinguishing characteristic used to determine the difference between antemortem and
postmortem tooth loss is related to the appearance of the tooth sockets. If a tooth has been lost postmortem,
the socket will show sharp edges or borders. Keep in mind, however, that a tooth displaying these
characteristics may have been lost a few days antemortem. If a tooth has been lost antemortem, the socket
will show signs of healing. Typically the socket will display rounded borders (healing/bone growth) and
varying degrees of bone growth in the socket. Bone growth can be observed in as little as 21 days. Within
six months, the socket will fill in. Within a year there can be complete obliteration of the socket.
8-7. The teeth most frequently lost postmortem are the anterior teeth, the incisors and canines. These are
typically single-rooted teeth, which are less firmly secured in the sockets than are the premolars and
molars.
8-8. After the dental remains are charted, they are compared to antemortem records to make a dental
identification. A high percentage of the general population visited a dentist at some time in their life. The
dental charts that dentists create are often maintained for long periods of time. In the military, the SF 603
(Health Record — Dental) is a permanent part of the individual’s health records.
8-9. Radiographs (X-rays) are indispensable in identifying dental postmortem remains. Antemortem
radiographs are, perhaps, the single most valuable antemortem dental record for purposes of comparison in
dental identifications. Radiographs provide hard evidence of dental records. They are not subjected to
human error to the same extent as are written dental records. They present an objective, accurate, and
unique record of an individual’s dentition. Radiographs show many conditions that are only detectable by
this method. As such they are the most desirable antemortem record for dental identification. The U.S.
military has mandatory requirements for dental examinations that, in most standards, include radiographs.
The records are normally maintained for extended periods of time and are usually available for
comparison.
8-10. Radiographs provide additional multiple points of comparison for establishing identification.
Comparison of antemortem radiographs to postmortem radiographs allows the forensic odontologist the
greatest certainty for establishing an identification or exclusion. Radiographs will depict not only the shape
and size of restorations but also additional unique features that are invaluable for a dental identification.
Some of these features include root and bone morphology, root and bone pathology, impacted/unerupted
teeth, root canals, the shape and size of pulp chambers, anatomical landmarks, and surgical intervention.
8-11. A postmortem radiographic examination should include periapical and bitewing radiographs for
comparison to antemortem radiographs. If the equipment is available, postmortem panoramic radiographs
should be taken, as these are standard radiographs for military personnel.
8-12. Periapical radiographs (figure 8-1) show one tooth or several teeth and include the crown and root of
the tooth and the surrounding supporting bone and anatomical structures. They are taken separately of the
maxillary and mandibular teeth. Typically, two to four teeth will show fairly completely on one of these X-
rays. Periapical radiographs can be used for loose teeth, tooth fragments, the sockets of teeth that were lost
postmortem, edentulous areas, and areas, particularly the third molars, which may be impacted or
extracted.
8-2 FM 4-20.65 27 July 2005

Figure 8-1. Periapical radiograph11
8-13. Bitewing radiographs (figure 8-2) are the most common type of dental radiographs. Frequently, they
are the only type of antemortem radiograph available. Bitewing radiographs are taken of the maxillary and
mandibular teeth biting together (in occlusion) and show the teeth in close approximation. They show the
full crowns of the teeth with the surrounding supporting bone and anatomical structures. They do not,
however, show the areas around the end of the roots. If the maxilla and mandible are extremely
fragmented, radiographs of this type may be difficult to take. They should, however, be attempted. If it is
not possible, then periapical radiographs can be used for separate views of the maxillary and mandibular
teeth.
Figure 8-2. Bitewing radiographs12
8-14. A panoramic radiograph (figure 8-3) is one large film that shows the entire status of the mouth. It
shows all the maxillary and mandibular teeth and bony supporting structures in a comprehensive view. The
temporomandibular joints (where the mandible articulates with the skull at the temporal bone) and the
nasal and orbital regions of the skull are also shown.
11
Dr. Andrew M. Sklar.
12
27 July 2005 FM 4-20.65 8-3

Chapter 8
Figure 8-3. Panoramic radiograph13
8-15. Computer support now plays a major role in forensic dental identification. The basic principle is that
antemortem and postmortem information is entered into a database. Screening the dental records from a
pool of known individuals involved in a fatality creates an antemortem database. Thousands of
comparisons can be made and a list of possible candidates will be generated. This list is ranked to produce
a ‘most likely’ identities list. The forensic odontologist uses the list to assist in the final identification. The
list does not make an identification but reduces the number of records that the odontologist has to compare
manually. The odontologist will then confirm or reject the ‘most likely’ list by visual comparison of
antemortem and postmortem dental charts and radiographs. The first computer program to gain wide
distribution was CAPMI. This DOS program was developed in the 1980s at the U.S. Army Institute of
Dental Research to facilitate the rapid identification of remains. WinID is a windows based dental
identification program that, given the natural evolution of computers, will make CAPMI obsolete. WinID
was developed by Dr. James McGivney and was initially released as an upgraded version of CAPMI4.
WinID codes are an extension of CAPMI codes. WinID has proven useful in mass disaster situations and
in creating and maintaining missing person databases.
8-16. The final stage of the forensic dental identification involves comparing antemortem and postmortem
dental records and radiographs. With antemortem records and radiographs, postmortem records and
radiographs, and the computer-generated results, the comparison process can begin. A comparison
table/chart can be made for visual comparison and should contain information on all 32 teeth. The records
are compared for similarities and discrepancies. Discrepancies should be examined first as one discrepancy
can negate numerous similarities.
8-17. The records are reviewed for significant points of comparison, concordance. It is preferable to have
as many points of concordance as possible. However, there is no agreement within the field of forensic
odontology on how many points of concordance are sufficient for a positive identification. Each case is
assessed individually. The critical factor is to remove subjective judgment calls from dental comparisons.
8-18. After identification has been established, photographs should be taken of the antemortem and
postmortem dental radiographs that provided the conclusive evidence of the positive identification.
8-19. Although not conclusive, dental work may provide information on the region of origin and time of
the work as well as individualizing characteristics. This information is general and should be treated as
such. In a case of a mass disaster the information may be used to narrow the list of possible victims.
13
8-4 FM 4-20.65 27 July 2005

8-20. In general, people under thirty will have far less dental restorations than people over 30. People over
40 will be expected to have more prosthetic dental care, (crowns, dental implants, and fixed bridges).
People over 60 will be more likely to have removable prostheses (full or partial denture).
8-21. In general, women will have fewer broken and decayed teeth than men. By comparison, the
mandible and maxilla are smaller in women than in men.
8-22. Certain types of restorations are more likely to be found in a dental school or performed in the
military than in private practice. These restorations include gold foil, cast gold inlays and onlays, full gold
crowns, and amalgam restorations that are highly polished and have detailed anatomical carvings.
8-23. Dental fluorosis is much more common in individuals who live in a community with a high
concentration of fluoride in their water. Certain parts of the country have higher natural concentrations of
fluoride than others. (Colorado is known to have high concentrations of fluoride in the water supply.)
POSSIBLE CONCLUSIONS
8-24. There are four possible conclusions that the forensic odontologist may reach based on his
interpretation of the observed dental characteristics of the remains.
Positive Identification
8-25. The antemortem and postmortem data match in sufficient detail to establish that they are from the
same individual. No irreconcilable discrepancies are present which would exclude the individual.
Possible Identification
8-26. The antemortem and postmortem data exhibit some similar characteristics (restorative and/or
anatomical). There are no entries present to exclude the individual in question. But, due to the quality of
the remains and/or the antemortem evidence, it is not possible to positively establish dental identification.
Insufficient Evidence
8-27. The available information is insufficient to form the basis for a conclusion.
Exclusion
8-28. The antemortem and postmortem data are clearly inconsistent. Restorative and/or anatomical
characteristics are different and unexplainable. There is no reasonable explanation for the differences. The
remains are not those of the individual in question. It should be noted, however, that identification by
exclusion is a valid technique in certain circumstances.
FINGERPRINTING
8-29. The science of fingerprinting, technically known as dactyloscopy, provides an infallible scientific
means of personal identification. Fingerprinting consists of making ink recordings of the friction ridges on
the palmer sides of the fingertips to be compared to known fingerprints for identification purposes.
Fingerprints establish a positive and conclusive identification based on two scientific premises.
UNIQUENESS
8-30. No two fingerprints are alike, not even in identical twins, and not even on the hands of the same
person.
PERMANENCE
8-31. Fingerprints develop about the third to fourth month of the gestation period. They do not change
throughout the life of an individual (with the exception of size) barring serious injury to the papillary layer
of the skin or some sort of serious skin disease or until total decomposition of the body.
27 July 2005 FM 4-20.65 8-5

Chapter 8
8-32. Occupations requiring the handling of abrasive materials, corrosive chemicals, those which keep the
hands wet continually or constantly require the handling of paper products may impair the ridges on the
fingers. Temporary disfigurement may result from warts, cuts, infections, burns, and blisters; however, the
ridges assume their original characteristics after healing, as long as the papillary layer of the skin is not
damaged. Friction ridges can be purposely mutilated in an attempt to disguise the fingerprints to prevent
recognition. The scars created by this intentional tissue damage in and of themselves are unique and serve
as a means of identification.
8-33. Friction ridge detail is generated from the papillary region of the skin. The finger bulb is usually
defined as the area of friction ridge skin from nail edge to nail edge and from the tip of the finger to the
crease of the first joint. Figure 8-4 illustrates a cross section of friction skin showing its two basic layers—
the epidermis and the dermis. The epidermis consists of friction ridges on its surface, which provides for
friction allowing us to grip items. The dermis contains sweat glands which discharge a substance consisting
of approximately 98.5 percent water and 1.5 percent fats and waxes and other waste materials. It is this
watery substance, along with other contaminants contracted from other parts of the body, which aides in
fingerprint deposition.
Figure 8-4. Cross section of friction ridge skin
CLASSIFICATION
8-34. In 1896, Sir Edward Richard Henry introduced a sample comprehensive method for classifying
fingerprints. Classification provides a means for filing and searching large files of fingerprint records. It is
still used today in nearly all English-speaking countries. According to the modified Henry system used in
the United States all inked finger impressions are divided into three large general groups of patterns, each
with subdivisions. They are: arch (plain and tented); loop (radial and ulnar); and whorl (plain, central
pocket loop, double loop, and accidental).
8-6 FM 4-20.65 27 July 2005

8-35. The descriptions that follow are provided to give sufficient familiarity with the fingerprint patterns
and a working knowledge of the classification procedures so that the reader will be able to tell the
difference between the basic patterns.
Arch Pattern
8-36. The arch pattern is the simplest of all the fingerprint patterns and the easiest to identify. Only 5
percent of all fingerprints are arch patterns.
Plain Arch
8-37. In the plain arch pattern (figure 8-5), the ridges enter from one side of the pattern area, rise
noticeably in the center of the pattern area, drop back down, and exit the opposite side of the pattern area.
Figure 8-5. Plain arch pattern
Tented Arch
8-38. The tented arch pattern is characterized by ridges entering from one side of the pattern area, thrusting
upward in the center, dropping down, and then exiting the other side. The thrust ridges appear as though
they are arranged around a spine or axis. Tented arch patterns are divided into three distinct types.
z The type in which ridges at the center from a definite angle of 90 degrees or less (figure 8-6).
z The type in which one or more ridges at the center form an upthrust (figure 8-7). An upthrust is
an ending ridge of any length rising at a sufficient degree from the horizontal plane, that is, 45
degrees or more.
z The type, which resembles the loop pattern, has two of the basic or essential characteristics of
the loop but lacks the third (figure 8-8).
27 July 2005 FM 4-20.65 8-7

Chapter 8
Figure 8-6. Tented arch patterns, type with an angle
Figure 8-7. Tented arch patterns, type with an upthrust
Figure 8-8. Tented arch patterns, type resembling the loop
Loop Pattern
8-39. The loop pattern (figure 8-9) is the most prevalent of all; about 65 percent of all fingerprints are loop
patterns. In the loop pattern, one or more of the ridges enter from either side of the pattern area, re-curve,
and exit or tend to exit the same side of the pattern area which it entered. The two subdivisions of the loop
pattern are ulnar and radial loops. The terms are derived from the radius and ulna bones of the forearm. A
loop that flows in the direction of the ulnar bone (toward the little finger) is called an ulnar loop. A loop,
which flows in the direction of the radius bone, is called a radial loop. The direction of the loop is judged
by the way it flows on the hand.
8-8 FM 4-20.65 27 July 2005

Figure 8-9. Loop pattern
Whorl Pattern
8-40. About 30 percent of all fingerprints are the whorl pattern. In the whorl pattern the ridges are making
circles. The circuit may be spiral, oval, circular, or any variant of a circle. Variations of the plain whorl
pattern (figure 8-10) include the central pocket loop whorl pattern (figure 8-11), the double loop whorl
pattern (figure 8-12), and the accidental whorl pattern (figure 8-13).
Figure 8-10. Plain whorl pattern
27 July 2005 FM 4-20.65 8-9

Chapter 8
Figure 8-11. Central pocket loop whorl pattern
Figure 8-12. Double loop whorl pattern
8-10 FM 4-20.65 27 July 2005

Figure 8-13. Accidental whorl pattern
FINGERPRINTING PROCEDURES
GENERAL
8-41. Necrodactylography, the scientific study of identifying remains through fingerprints, includes the
restoration of the fingers of remains by using physical or chemical techniques to obtain identifiable
fingerprints. Fingerprints taken soon after death provide the best results. If they cannot be taken within a
reasonable time after death or before the remains arrive at the final processing point, each finger should be
injected with embalming fluid to retard decomposition so that impressions may be taken later. Fingerprints
of all digits of each hand must be taken regardless of other identifying media, including any previously
recorded fingerprints.
POWDER AND LABEL METHOD

8-42. The USACIL Latent Print Division recommends the powder and label method taught by New
Scotland Yard, Metropolitan Police Department, London, England. This is one of the simplest methods for
obtaining postmortem record fingerprints. The background of the white labels and the contrasting
fingerprint powder in this method creates extremely good quality record postmortem fingerprints.
8-43. Required materials are black fingerprint powder, fingerprint brush, white administrative case file
labels (cut to 1½ inches x 1½ inches), blank transparencies or document protectors, and a marker pen. The
method is as follows:
z Step 1.To begin, premake transparencies of a fingerprint chart and have them on hand. (Simply
run the transparencies through a copier machine or use document protectors if a copy machine is
not available.)
z Step 2. Brush fingerprint powder onto the bulb of the finger of the right thumb of the deceased.
(Starting with the right hand and maintaining the order of thumb, index, middle, ring, and little
finger for both hands will help to stay organized and avoid mistakes.) Powder the entire finger
bulb from tip just below the crease of the first joint and from nail edge to nail edge.
z Place a precut label over the powdered finger and gently smooth out the label, molding it to the
finger.
27 July 2005 FM 4-20.65 8-11

Chapter 8
z Step 4. Gently and steadily peel the label from the finger and attach it to the backside of the
transparency. This will allow the fingerprint to be viewed from the front side of the form and in
its proper perspective. If using blank transparencies, immediately label the print on the front of
the transparency, just below the labels—right thumb, right index finger, and so forth.
Note. The powder and label method is a much quicker and easier method for fingerprinting the
deceased. Some of the other methods, however, may still have to be employed in cases wherein
fingers are too damaged to allow for powdering of the skin.
FINGERPRINT IDENTIFICATION KIT

8-44. The Fingerprint Identification Kit (figure 8 -14), or a similar kit, is used, and the prints are recorded
on a fingerprint chart when fingerprinting deceased persons. The fingerprint kit contains a carrying case,
black printer’s ink, a spoon- or shovel-type cardholder, a tabletop cardholder, an inking slab or plate, and
an inking roller. Also included is a dental examining mirror used to examine teeth for charting.
Figure 8-14. Fingerprint identification kit
FINGERPRINTING THE NEWLY DEAD

8-45. When the fingers are flexible, it is often possible to obtain record fingerprints of a newly deceased
person by using the regular fingerprinting process. Successful prints can be obtained with the decedent
lying on his or her back with hands turned palm down by his or her sides. Procedures to be used are as
follows:
z Check the decedent’s hands to make sure they are clean and free of contaminants and to make
note of scars and other marks.
z Check the fingerprinting equipment to make sure that it is serviceable and clean.
z Prepare a fingerprint chart. .Fold and place fingerprint chart in the tabletop cardholder (figure 8-
15a) as described in steps 1 and 2.
8-12 FM 4-20.65 27 July 2005

Step 1. Fold the fingerprint chart horizontally below the heading block and above the FBI
block. All that should be showing are the print panels and the information block in the
center (figure 8-15b).
Step 2. Lift the bar on the cardholder and slide the folded form forward under the bar until
blocks 1 through 5 are positioned at the front of the cardholder (figure 8-15c). Press down
on the bar until the form is secured in the holder. After the fingerprints have been made in
blocks 1 through 5, remove the folded form and reverse the position of the card so that
fingerprints can be recorded in blocks 6 through 10. Note that in the cardholder, the order of
the blocks from left to right is 10 through 6.
z Prepare inking plate as follows:
Apply a dab of ink to the inking plate and spread thoroughly with the roller until a thin,
even layer covers the entire surface.
Note. If there is too much ink on the plate, the prints will likely be smudged or blurred. Use the
roller to remove excess ink by rolling it off onto clean bond paper to prevent over inking of
records.
Note. If there is too little ink or the ink is irregularly distributed, light spots will appear on the
prints and areas will be missing. Under inking can cause prints to lack sufficient contrast for
effective comparison.
z Apply ink as described on page 8-15.
27 July 2005 FM 4-20.65 8-13

Chapter 8
Figure 8-15a. Folding and placing fingerprint chart in tabletop cardholder
Figure 8-15b. Information block
8-14 FM 4-20.65 27 July 2005

Figure 8-15c. Positioning in cardholder
8-46. Apply ink to the fingers (figure 8-16a), one at a time, from the inking plate or pad. Grasp the hand
firmly and extend only one finger at a time. The hand is rotated so that the side of the finger can be placed
on the ink plate or pad. While one hand is grasping the hand of the subject, the other hand is holding the
end of the finger being printed to keep it from slipping and to apply light pressure. The finger is then
rotated on the ink plate or pad until the other side of the finger is on the plate/pad. It is recommended that
the direction of the roll of the digit be toward the body for the thumbs and away from the body for the
fingers. Make sure the bulb of the finger is inked evenly from the tip to approximately ⅛ inch below the
first joint. Press the finger lightly on the card and roll in exactly the same manner in which it was inked
(figure 8-16b).
Figure 8-16a. Inking finger
27 July 2005 FM 4-20.65 8-15

Chapter 8
Figure 8-16b. Printing rolled impression
8-47. If it is difficult to get fingerprints by the tabletop cardholder method described above, then the 10
squares numbered for rolled fingerprints may be cut from a fingerprint chart for easier use. After the finger
is inked, the square is rolled around the finger without letting it slip. Extreme caution should be exercised
to be sure that each square bears the correct fingerprint. After all fingers are recorded, the 10 squares
bearing the impressions are pasted or stapled to the fingerprint chart in their proper positions. In some
cases, a broad-bladed putty knife or a spatula may be used as an inking instrument. The ink is rolled evenly
and thinly on the tool and applied to the finger by passing the tool around it. The tool replaces the inking
slab or plate, which may be extremely difficult or awkward to use when printing a deceased person.
FINGERPRINTING REMAINS WITH STIFF FINGERS AND SIGNS OF DECOMPOSITION

8-48. The second group of remains consists of those with the hands clenched, the fingertips wrinkled, or
with decomposition beginning. Any combination of these conditions may also be present. (Such cases may
necessitate cutting off the skin. See page 8-19.)
Hands Clenched
8-49. When rigor mortis has set in and the fingers are tightly clenched, the fingers may be forcibly
straightened by “breaking the rigor.” The operator firmly holds the hand of the deceased, grasps the
stiffened finger to be straightened, places his thumb to serve as a lever on the knuckle of the stiffened
finger, and forces it straight (figure 8-17). Methods used to take fingerprints under these conditions are
given below.
Note. Rigor should only be broken when directed by the medical examiner. Breaking rigor has
the potential to introduce postmortem damage that, if not documented, may be misinterpreted as
perimortem damage.
8-16 FM 4-20.65 27 July 2005

Figure 8-17. Breaking rigor
8-50. If the rigor cannot be completely overcome, the spoon- or shovel-type cardholder is used to make
fingerprints (figure 8-18). The operator places in the cardholder a folded fingerprint chart or an individual
square cut from the form. Use of the shovel eliminates having to roll the deceased’s finger. The hollow in
the cardholder and the gentle pressure applied to the inked finger when brought in contact with the square
results in rolled fingerprint without actually rolling the finger. The fingerprint chart is folded and placed in
the shovel-type cardholder as shown in Figures 8-18 and 8-19 and described in the steps below.
Figure 8-18. Using the shovel-type cardholder

z Step 1. Fold fingerprint chart lengthwise in the center (figure 8-19a).
z Step 2. Fold the print panels back so that the fingerprint chart is shaped like the letter M (figure
8-19b).
z Step 3. Flatten the form (figure 8-19b) so that only the print panels show.
z Step 4. Slide the form into the slots on the shovel and adjust the form so that the finger block to
be used is positioned in the hollow of the shovel with the printing at the top of the print panels
toward the operator as he holds the handle of the cardholder (figure 8-19c).
27 July 2005 FM 4-20.65 8-17

Chapter 8
Figure 8-19a. Folding and placing fingerprint chart in shovel-type cardholder
Figure 8-19b. Folding and placing fingerprint chart in shovel-type cardholder
8-18 FM 4-20.65 27 July 2005

Figure 8-19c. Folding and placing fingerprint chart in shovel-type cardholder
Wrinkled Fingertips
8-51. The presence of wrinkles can hamper the complete recording of fingerprints. This condition is
mostly caused by maceration (long immersion of the fingers in water). It can be corrected by injecting a
tissue builder (glycerin) or even water into the finger bulb with a hypodermic syringe. The needle is
inserted just below the crease of the first joint of the finger and up into the finger bulb area (figure 8-20).
Care must be taken to keep the needle below the skin surface. The fluid is injected until the finger bulb is
rounded out. The finger is then inked and printed as in a normal situation. Occasionally, the fluid may not
completely fill the finger bulb and in such cases, injections can be made at the extreme tip or sides of the
finger until suitable results are obtained. The tissue builder hardens shortly after injection, whereas glycerin
and water can seep out when pressure is applied to the finger bulb during printing. Seepage can be
prevented by tying a piece of string around the finger just above the injection point.
Note. When tissue builder is used, care should be exercised to clean the syringe and needle
thoroughly because the tissue builder will harden in the instruments.
Figure 8-20. Injecting finger with tissue builder
Early Decomposition
8-52. Decomposition in its early stages causes the outer layer of skin to peel from the fingers. If the skin is
still in one piece, prints should be made as though the skin were attached to the finger. It may be better,
however, in some cases to peel the skin off the finger in one piece, place it over the gloved finger of the
operator, and ink and print it as though it were his own finger. If the first layer of skin is missing, a print of
27 July 2005 FM 4-20.65 8-19

Chapter 8
the second layer should be made, using the same techniques described above. Since the ridge detail on the
second layer is not as distinct, more attention and care is needed to get good fingerprints.
FINGERPRINTING BADLY DECOMPOSED REMAINS

8-53. Fingerprinting badly decomposed remains presents difficulties not encountered in fingerprinting
remains where the flesh is fairly firm and the ridge detail intact. The technique for treating fingers in
various stages of decay depends upon the condition of the fingers. When remains are badly decomposed,
the hands should be examined initially to determine if all the fingers are present. If some are missing, it
should be determined whether they were amputated during the person’s lifetime, amputated postmortem, or
whether they were destroyed by animal, marine life, or combat. The results of the examination should be
noted on the fingerprint chart. Dirt, silt, grease, and other foreign matter on the fingers should be removed
during this initial examination. Soap and water or xylene can be used as a cleaning agent. Xylene readily
cleans grease and fatty matter from the fingers. A soft-bristled brush may be used on fairly firm skin. A
cotton swab should be used on less firm skin.
8-54. After the fingers are cleaned, a further examination is made to determine their condition, based upon
the circumstances in which the body was found. There are three general types of conditions: decomposition
or putrefaction, prevalent in bodies found in brush or buried in earth; desiccation or mummification (dried
out) noted in bodies found in the open or bodies subjected to severe heat or burning; and maceration (water
soaking), resulting ordinarily from bodies being immersed in water. The degree of decomposition,
desiccation, or maceration can vary from an early to an advanced stage. Each remains must be considered
individually. The technique used to fingerprint one badly desiccated remains may not be the right
technique for another. The techniques described here have been used successfully.
8-55. When a body is found, the hands are usually clenched. The first problem is to straighten the fingers
to determine if there is any ridge detail. If desiccation of the hands precludes straightening of the fingers,
the difficulty can be overcome by using a scalpel to make a cut at the second joint on the inner side of each
of the four fingers (figure 8-21). The fingers can then be straightened by applying force. The thumb, if it is
bent, can generally be straightened by making a deep cut between the thumb and the index finger.
Figure 8-21. Making deep cut at second joint to straighten finger
Advanced Decomposition
8-56. When the remains are in an advanced state of decomposition, the operator is confronted with the
problem of dealing with rotten or putrefied flesh, which may be soft or flabby and very fragile. Procedures
vary according to whether the outer skin is present and intact or whether better prints can be obtained from
the underside of the skin or from the second layer of skin. At times, photographing the skin may give better
results than fingerprinting.
8-20 FM 4-20.65 27 July 2005

Fingerprinting Outer Skin

8-57. When the outer skin is present and intact and the ridge detail is evident, the standard method of
inking and printing may be possible. However, the skin may be too soft and fragile to ink and roll in the
usual way. When this occurs, either the skin is removed from the finger or the finger is cut off at the
second joint. The finger or the skin, whichever is used, is hardened in a 10 to 15 percent solution of
formaldehyde for approximately one hour. Skin placed in this solution usually turns a grayish white and
becomes firm and pliable. The skin may become brittle, however, and split if not handled carefully. The
skin is kept in the solution until it hardens sufficiently for handling. When it is removed from the solution,
it is carefully wiped dry with a piece of cloth. Then the skin, placed over the gloved thumb or index finger
of the operator and held in place by his other hand, is inked and rolled as though he were printing his own
finger.
8-58. While the finger is soaking in the formaldehyde, the skin may swell and come loose from the finger.
Should this occur, the skin must be removed carefully and the procedure outlined above must be followed.
If, however, the skin still adheres to the finger and is not too wrinkled, ink may be applied and prints made.
Should the skin be intact but too wrinkled to obtain a satisfactory impression, tissue builder can be injected
under the skin to fill out the pattern area. The finger is then inked and printed as usual.
8-59. When part of the skin has been destroyed to the extent that tissue builder cannot be injected
effectively and the pattern area is present but wrinkled, the entire pattern area should be removed by
cutting off the first joint of the finger (figure 8-22). Care must be exercised to ensure that the complete
fingerprint pattern is removed, with the cut made deep enough to allow the skin to be removed without
causing damage to the area of interest. Carefully remove any excess flesh from the underside of the
removed skin by scraping, cutting, and trimming until only the outer layer of skin remains, or until the
specimen is so thin that it can be flattened out to remove most of the wrinkles. If the skin is fairly pliable,
the operator should attempt to place it over one of his own fingers and try to record several prints. If the
prints obtained are not suitable, the piece of skin should be flattened out between two pieces of glass and
photographed (figure 8-23). If a satisfactory print is not obtained, the underside of the skin should then be
examined.
Figure 8-22. Removing pattern area from first joint
Fingerprinting Underside of Skin

8-60. In many instances when the ridge detail on the outer surface has been destroyed or cannot be seen,
the ridge detail is clearly visible on the underside. If so, the skin is carefully turned inside out to prevent
splitting or breaking and is then inked and printed in the usual manner. It must be remembered, however,
that when the underside of the skin is printed, the impression is in reverse position; that is, the ink is
actually adhering to what would be the furrows of the pattern. If it is thought that turning the skin inside
out will damage it, a photograph of the inner ridge detail is made and the negative is printed in reverse for
comparison purposes. A good photograph of the ridge detail might be obtained by trimming the skin and
flattening it between two pieces of glass (figure 8-23).
27 July 2005 FM 4-20.65 8-21

Chapter 8
Figure 8-23. Fingertip skin trimmed and flattened between two pieces of glass before being
photographed
Fingerprinting Lower or Dermal Layer of Skin

8-61. The dermal layer of skin has the same ridge detail, though finer and less pronounced, as the outer
layer (figure 8-24). The lower layer is just as effective for identification purposes. These facts are
particularly helpful to know when decomposition has destroyed the outer layer of skin, or it is in such a
condition as to be of no value. If the outer layer of skin is missing and the second layer is intact, the finger
should be cleansed, dried, inked, and printed in the usual manner. If some of the outer skin remains
attached, carefully pick and pry it off with a scalpel being careful not destroy or damage the lower layers.
The second or dermal layer of skin is composed of what are called dermal papillae, which have the
appearance of minute blunt pegs or nipples. The dermal papillae are arranged in double rows. Each double
row lies deep in a ridge of the surface or epidermal layer and presents the same variations of ridge
characteristics as are on the outer layer of skin except that they are double. Accordingly, when the second
layer of skin is printed or photographed, the ridge detail will appear in double. This can confuse the
examiner in that what may be a loop having ten ridge counts may appear to be a loop with twenty ridge
counts.
Figure 8-24. Ridge detail seen on dermis after charred epidermis removed
Desiccation
8-62. The main problem in treating desiccated or dried and shriveled fingers is how to stretch out and
soften the skin. The desiccated skin is usually intact and the ridge detail fairly clear. However, numerous
wrinkles are present and as the drying process continues, the skin and flesh harden until the fingers become
almost as hard as stone. The skin can be stretched and softened by soaking it in a hydroxide solution. If the
results are unsuccessful, the pattern area can be removed and printed or photographed. Satisfactory prints
can also be obtained by using silicone casting materials or liquid latex.
Soaking in Hydroxide
8-63. By soaking the fingers in a 1 to 3 percent solution of sodium hydroxide or potassium hydroxide
(caustic potash), the flesh can sometimes be swelled. It is best to try one finger at a time because even as
the flesh is absorbing the solution and is swelling, it is being destroyed by the hydroxide. The finger to be
soaked in the hydroxide is cut from the hand at the second joint. When it reaches its normal size by
absorbing the hydroxide, it is inked and printed. There is no set time for this process. It may take from a
few hours to as much as 10 days. A close watch is maintained—beginning 30 minutes after the finger is put
in to soak. If the skin peels, the loose skin is scraped off and the finger is rinsed in water and returned to
8-22 FM 4-20.65 27 July 2005

the solution. If the finger has not reached full size after several hours, it is placed in water for an hour or so
to hasten the swelling.
8-64. When removed from the water, the finger is coated with a film. Then it is scraped and replaced in the
hydroxide for an hour or so more. If the flesh becomes too soft, the finger is placed in a 1 to 3 percent
solution of formaldehyde or alcohol for several minutes to harden. This process of alternating from the
sodium hydroxide solution to water, scraping, and replacing in solution is continued until the desired result
is obtained. Subsequently the finger can be inked and printed. However, if the finger becomes over
saturated and will not print properly, it should be dipped in acetone for a few seconds, removed, and
permitted to dry after which it is inked and printed. If satisfactory results are obtained with one finger the
rest of the fingers are given the same treatment.
Removing the Pattern Area

8-65. If the reaction of the hydroxide solution on the first finger treated is not satisfactory, and it is
doubtful that further soaking would give satisfactory results, the treatment is discontinued. The finger is
removed from the solution, washed carefully in water, and placed in formaldehyde to harden sufficiently
for handling without damaging the ridges. Then the pattern area is cut off in such a way that sufficient
surrounding surface permits the skin to be trimmed. Carefully scrape and cut to remove the excess flesh.
During the cutting and scraping process from time to time, the skin is soaked in xylene and massaged to
soften it and to remove wrinkles. When the skin is thin enough and sufficiently pliable, the operator places
the skin on his or her own gloved finger, inks, and prints it. If the results are satisfactory, the same
procedure is followed with the remaining fingers. If the prints are not suitable, the skin is scraped until it
can be flattened between two pieces of glass and photographed (figure 8-23). If there is poor contrast
between the ridges and the furrows when direct light is used, transmitted light should be used instead.
Using Modeling Clay

8-66. Modeling clay can be used to make satisfactory impressions of macerated, desiccated, and charred
fingers according to the following steps:
z Step 1. Shape one end of a stick of ordinary modeling clay to resemble the head of a small
mushroom. It should be large enough to cover the pattern area of the bulb of the finger.
z Step 2. Apply the mushroomed end of the clay to the inking plate.
z Step 3. Firmly press the inked clay against the pattern area several times to ensure an even
inking of the finger bulb.
z Step 4. Press a ¼-inch layer of modeling clay into the concave section of the shovel-type
cardholder. Then cover the clay with a thin piece of plastic or paper on which to record the print.
z Step 5. Press the inked finger against the paper or plastic, which adapts itself to the contours of
the finger as the clay base yields. Rolling the finger is unnecessary. If the finger seeps an
excessive amount of fluid, white plastic lifting tape may be substituted for the plastic or paper to
prevent slippage and blurring.
Using Plastic Casting Material

8-67. Before plastic casting material is applied, the fingers must be thoroughly cleaned and dried. The
plastic material is applied in small drops, which are spread out to form a thin even layer to cover the whole
papillary pattern of the finger bulb. When all the fingers have been treated in this way, they should remain
at room temperature for about 30 to 60 minutes or until the casting material has dried. The casts are then
carefully removed and each cast is placed between glass slides along with the number of the finger.
8-68. Liquid latex may be used to make a cast according to the following steps:
z Step 1. Dip each finger into the latex and let it dry. Repeat this step several times until a cast
approximately 1/32-inch thick is built-up to prevent its tearing.
z Step 2. When the last coat is dry and the cast changes to flesh color, remove it by rolling it from
the finger.
27 July 2005 FM 4-20.65 8-23

Chapter 8
z Step 3. Roll the cast onto the operator’s finger, ink, and record it on the fingerprint chart. Note
that the flow and color of the ridges in latex impressions are the reverse of prints made by the
fingers themselves.
8-69. Bodies which have been burned or subjected to severe heat are included in the desiccation cases, but
the techniques for fingerprinting them differ from other desiccated cases. Often there are instances when
the skin has become loose but is hard and crisp, or when the finger has been severely burned and is reduced
almost to carbon, yet is firm. In such cases, the ridge detail usually has not been destroyed (figure 8-24).
8-70. When a severely burned body is located, the problems of identification should be anticipated. Before
the body is removed, the fingers should be carefully examined to determine if transporting the remains
would in any way cause damage to the fingers or ridge detail. If damage could be incurred, consideration
should be given to securing fingerprints at the scene.
8-71. An examination of the fingers may show that the outer skin is hardened and is partially loosened
from the flesh. It is sometimes possible to remove this outer skin intact by twisting it back and forth. If this
is done, the operator may place the skin on his own gloved finger, ink it, and print it in the usual manner. If
the skin is intact and is unwrinkled, recordings are made in the usual manner.
8-72. Should wrinkles be present and the skin pliable, tissue builder is injected into the bulbs, which are
inked and printed. If the wrinkles cannot be removed, then the pattern area is cut off and the procedure
given on page 8-19 is followed.
8-73. In some instances, the fingers of burned bodies are charred. Such cases require careful handling as
the ridge detail can be destroyed or disturbed through mishandling. In these cases, the procedure is
determined by the degree of charring. In extreme cases, the only method of recording is by photography
using side lighting to obtain the proper contrast of ridges and depressions. Obviously, no attempt should be
made to ink and roll the prints, as the pressure necessary to secure the prints would cause the skin to
crumble. When extreme charring has not occurred, the procedures previously given for treating the skin by
cleaning, softening, inking, and printing or photographing should be followed.
Maceration
8-74. Maceration, or the long immersion of the fingers in water, presents a problem in obtaining legible
impressions. One important rule in making legible prints is that the fingers must be dry. In addition to
drying the fingers, other difficulties must be overcome. Usually the skin on the fingers absorbs water,
swells, and loosens from the flesh within a few hours after immersion. If the skin is water soaked,
wrinkled, and pliable, but intact, the skin is carefully cleaned as described earlier. Then the fingertip is
wiped with alcohol, benzene, or acetone and given a few seconds to dry. After the skin is dry, it is pulled or
drawn tight across the pattern area so that a large wrinkle forms on the back of the finger. The bulb is then
inked and printed.
8-75. If the skin is broken and hanging loose but the pattern area is intact, the skin is removed from the
finger and cleaned by placing it in alcohol or benzene (not acetone) for about a minute. Then it is stretched
carefully over the operator’s gloved finger to remove any wrinkles before it is printed.
8-76. Sometimes the skin is intact on the finger, but it is so wrinkled and hard that it is not possible to draw
it tight for inking. If so, tissue builder may be injected to round out the bulb for inking and printing. Should
this procedure fail, the ridge detail is photographed on the finger or the skin is cut off and flattened
between two pieces of glass and photographed.
8-77. When the ridge detail does not show on the surface of the outer skin, the underside should be
examined to determine if the detail could be seen more clearly. If so the underside of the skin is
photographed.
8-78. When the outer skin is gone and the finger is not saturated with water, it is possible to dry the surface
sufficiently for inking and printing by rolling the finger on a blotter. If this fails, the finger is wiped off
with a piece of cloth saturated with alcohol, benzene, or acetone and then inked and printed.
8-24 FM 4-20.65 27 July 2005

8-79. When the outer skin is gone and the fingers are saturated with water, they must be dried out quickly
by placing them in full strength acetone for approximately 30 minutes. The fingers are then placed in
xylene for about an hour or until the xylene has overcome the reaction of the acetone. After the fingers are
removed from the xylene, they are placed on a blotter to dry. When finger surfaces appear to be dry, they
are ready to be inked and printed. When the fingers are removed from the acetone, they dry and harden in a
matter of seconds. Xylene can be used to resoften the fingers.
PHOTOGRAPHIC TECHNIQUES
8-80. Ridge detail should be photographed when inked recordings are unsuitable for classification and
identification purposes. Black and white photography is best suited for recording fingerprint ridge detail.
Black and White Photographs

8-81. Panchromatic and so-called soft films are suitable for this work. If high-contrast film is used, some
of the ridge detail may be lost, especially if the skin is wrinkled. The ridge detail should be photographed
at its natural size, which is one to one (1:1) to allow comparisons with inked impressions at the same ratio.
A yellow or light red filter should be used when fingers or skin have a mottled, reddish brown color caused
by decomposition, nearness to severe heat, or diffusion with blood. Such a discoloration presents a
problem in making a photograph because the ridges and depressions of the skin lack contrast.
Discoloration from diffusion with blood may be removed by saturating and rinsing the specimen in a 10- to
20-percent solution of citric acid. Direct, side, transmitted, or reflected lighting may be used in
photographing ridge detail. The type of lighting used depends on the condition of the finger or skin.
z Direct lighting is used when the ridge detail is fairly clear and no wrinkles, or only shallow ones,
are present.
z Side lighting is used when there are no wrinkles of any consequence and the ridge detail is clear.
If discoloration prevents ridges from being seen readily in the viewer, the light should be placed
at the side and directed across the skin or finger to highlight the ridges and depressions.
Although two lights may be used, a single spotlight may produce better results as the beam can
be controlled.
z Transmitted lighting is used when the skin has peeled off or when the dermis has been removed
and scraped thin so that light will go through it. With the prepared skin flattened between two
pieces of glass and the lights placed behind the skin and directed through it, the ridge detail can
be brought into focus (figure 10-25). However, if the contrast between the ridges and
depressions is not sufficient when the skin is dry, better results may be gained by placing the
skin in xylene during the photographing of the skin. The skin is placed upright in a test tube or
small bottle, with the ridges of the skin toward the camera. If the skin is thin enough, transmitted
lighting is used; if not, direct lighting is used. If the skin produces a hot spot, which cannot be
removed by rearranging the lights, reflected lighting is used.
27 July 2005 FM 4-20.65 8-25

Chapter 8
Figure 8-25. Epidermis mounted on glass slide photographed with back lighting
z Reflected lighting. The effect of reflected lighting is obtained by cutting a hole in the center of a
large piece of paper or cardboard. The hole must be large enough for the camera lens to protrude
through. The ends of the paper or cardboard are curved toward the skin or finger being
photographed. The lamps are placed facing the curved paper or cardboard so that the light
strikes the paper or cardboard and is reflected by the curved surface to the object. The lamps are
placed close enough to give maximum light but not so close that they produce a fire hazard.
Photographic Print Impressions

8-82. When a comparison of fine structured detail is needed, prints may be made with a photographic
developer—using glossy photographic print paper. The developer is applied lightly to the fingertip and
rolled lightly on the paper. Then it is placed in an acid-fixing bath for approximately 30 minutes and
washed in the same way as the ordinary photograph. This process yields a highly detailed print.
FOOTPRINTING
8-83. Footprints are obtained in the same manner as fingerprints. Briefly, use an ink roller to coat the
bottom of the foot. Secure a footprint chart to something flat and stable, like a clipboard. Take a straight-
on, flat impression of the left and right foot. Alternately, secure a footprint chart to a cylinder and roll the
entire foot, heel to toes. The feet must be clean and dry.
DEOXYRIBONUCLEIC ACID (DNA)

8-84. DNA is a double-stranded molecule that is hydrogen-bonded together and twisted to form a double
helix (figure 8-26). It resembles a long, twisted ladder or zipper. DNA is often described as the body’s
blueprints as these molecules carry the genetic codes that govern individual traits and the structure and
function of every component of the body. For example, DNA is the material that governs inheritance of
eye color, hair color, skin color, and stature.
8-26 FM 4-20.65 27 July 2005

Figure 8-26. The double helix
8-85. Each individual’s DNA is different from that of every other individual in the world, except for
identical twins. Like fingerprints each person has a unique DNA fingerprint. The DNA fingerprint is the
same for every cell, tissue, and organ that makes up an individual’s body.
8-86. DNA must be recovered from the cells or tissues of the body. Only a small amount of biological
evidence—such as blood, skin, hair, or semen—is needed.
DNA USES
8-87. Forensic science uses techniques developed in DNA research to identify individuals who have
committed a crime and to identify unknown individuals. DNA is also used in paternity cases. DNA is
particularly useful in the identification process when the remains have been damaged by fire, severely
fragmented, commingled in a mass disaster, or decomposed. The U.S. Armed Forces collects DNA
bloodstain cards from all military personnel. Department of Defense Directive 5154.24, Subject: Armed
Forces Institute of Pathology (AFIP), October 2001, requires all active duty personnel in the U.S. military
to submit a reference DNA sample (blood). The sample is retained by the Armed Forces Institute of
Pathology in the event that a comparison to a specific individual is needed in the future.
DNA PROFILING
8-88. DNA fingerprinting, more appropriately called DNA profiling, makes it possible to compare samples
of DNA from various sources (such as comparison of a sample from a BTB remains to a sample obtained
antemortem) in a manner comparable to the comparison of fingerprints. Very basically, the DNA in a
sample is isolated and then specific sections of DNA are targeted for analysis using a technique called
PCR. This is like a biochemical “Xerox” of the target section of DNA and millions of copies can be made.
Those target sections are then analyzed on the basis of their unique sizes or sometimes unique sequence
(letter-by-letter code). The more sections of DNA that are analyzed, the more of a distinctive DNA profile
can be established.
8-89. There are two types of DNA that are used in DNA profiling.
Nuclear DNA
8-90. The preferred method in the forensic community is based on nuclear DNA. There are only two
copies of nuclear DNA per human cell. Half an individual’s nuclear DNA comes from the biological
mother and the other half comes from the biological father. Thus, a child is a biological “copy” of the
mother and father because of the inherited nuclear DNA. To obtain an identification, the DNA profile from
27 July 2005 FM 4-20.65 8-27

Chapter 8
the unidentified individual is compared to the profile from a sample known to have come from the
individual BTB deceased or sometimes, can be reconstructed if DNA samples are taken from the parents.
8-91. Over time, as the biological sample ages, DNA breaks down. In some cases—such as skeletal or
badly decomposed remains—it is not possible to extract nuclear DNA. In these cases, mtDNA is used.
While there are only two copies of nuclear DNA per cell, there are approximately 1,000 copies of mtDNA
per cell. Thus in cases where nuclear DNA cannot be analyzed, mtDNA may be present in sufficient
quantities for analysis.
Mitochondrial DNA
8-92. Mitochondrial DNA is maternally inherited; it is passed from mother to child. Mitochondrial DNA is
not inherited from the father. A mtDNA sample from the remains can be compared to a sample from the
mother or any brothers and sisters in the same maternal line (figure 8-27). Even samples from nieces and
nephews and cousins can be used as references, but only if they share the same maternal ancestry as the
victim.
Figure 8-27. Eligible donors of mtDNA samples
8-93. The nature of mtDNA allows comparison of the sample from the deceased to reference samples from
family members separated by generations. It is important in the identification of individuals for which there
is no antemortem comparison sample. However, mtDNA is not unique to a specific individual. It cannot,
therefore, be used by itself for a positive identification and must be used in corroboration with additional
circumstantial information.
DNA HARVESTING
8-94. There may be circumstances, such an unprecedented mass disaster or deaths from weapons of mass
destruction, when temporary interment of remains is required. In these instances, protecting the living will
be paramount and available resources will be consumed taking care of the injured in the immediate
aftermath of the incident. The AFMES has developed a procedure to obtain a DNA sample quickly and
safely when remains cannot be returned to CONUS for examination. Harvesting DNA samples will ensure
a positive identification and thus provide for full accounting of fallen service members. This procedure will
also minimize the risk to the living.
8-28 FM 4-20.65 27 July 2005

8-95. The AFMES directs that the right index finger will be harvested with a shears. The finger should be
removed at the articulation of the distal metacarpal and the proximal phalanx, the area of the first knuckle
(figure 8-28). This sample is easy to obtain in MOPP gear; requires minimum exposure time to obtain (less
than one minute); and requires no needles, knives, or scalpels. If the right index finger is unavailable, select
another available finger. If fingers are unavailable, select a portion of a narrow bone (clavicle, rib, and so
forth) that will fit in the specimen tube. Teeth and deep muscle are the next sequential choices; do not send
fat tissue.
Figure 8-28. Removal of the index finger
8-96. The finger will be obtained in country and shipped to the AFIP in the Saf-T-Pak System. (The Saf-T-
Pak system consists of the Fitzpak Transport Tube, STP-100 Infectious Substance Shipper, and the STP-
350 Saf-T-Case.)
8-97. Apply the bar code label to the Fitzpak Transport Tube. The vial must be dry when the bar code is
applied. The bar code label must be applied flush against the tube and in a lengthwise direction. The bar
code label is a portion of the LISA Lite System—a computer application designed for use by personnel
involved in entering data regarding DNA specimens collected in the field.
8-98. The specimen is placed in the Fitzpak Transport Tube (figure 8-29). The tube is filled with a 10
percent formalin solution or 100 percent Isopropanol. The tamper evident cap is screwed onto the top of
the transport tube. The transport tube is then dipped in a standard commercial bleach solution.
Figure 8-29. Fitzpak Transport Tube, DNA sample collection container
27 July 2005 FM 4-20.65 8-29

Chapter 8
8-99. Up to six transport tubes are placed in the STP-100 Infectious Substance Shipper container (figure 8-
30 and figure 8-31). The lid is secured. The container is dipped in a standard commercial bleach solution.
Figure 8-30. STP-100 Infectious Substance Shipper container
Figure 8-31. STP-100 Infectious Substance Shipper with six transport tubes
8-100. Up to eight containers are placed in the STP-350 Saf-T-Case (figure 8-32 and figure 8-33). The
case is closed and the lid secured for air shipment. The container is sealed with evidence tape and a plastic
tamper-proof seal. A keyed lock is not necessary.
Figure 8-32. STP-350 Saf-T-Case
8-30 FM 4-20.65 27 July 2005

Figure 8-33. STP-350 Saf-T-Case holding seven STP-100 Infectious Substance Shipper
containers
8-101. The Saf-T-Pak System is in compliance with all hazardous materials regulations. All national and
international requirements for use by surface and air transport have been met.
8-102. Extraction of the sample will take place in a level 3 laboratory at AFIP. A fingerprint will be taken
before extraction. DNA testing will be conducted by the AFDIL.
27 July 2005 FM 4-20.65 8-31

Chapter 9
IDENTIFICATION OF SKELETAL REMAINS
OBJECTIVE
9-1. To provide the mortuary affairs specialist with a basic knowledge of forensic anthropology to assist
forensic experts with charting skeletonized human remains.
FORENSIC ANTHROPOLOGY
9-2. The American Board of Forensic Anthropology defines forensic anthropology as the application of
the science of physical anthropology to the legal process. Forensic anthropologists apply standard scientific
techniques to identify human remains and assist in detecting crime. Forensic anthropologists are typically
called upon when conventional means of identification—such as visual identification, dental identification,
or fingerprints—fail to make a positive identification.
9-3. The basis of all forensic anthropological analysis is human osteology (the science of the anatomy
and structure of bones). Forensic anthropologists assist medical and legal specialists to identify human
remains, to reconstruct the biological profile of the living individual from the skeleton, to estimate the time
since death, and to determine the cause of death (gunshot wound to the head, stab wound, and so forth).
Due to the skeletonized nature of the remains, findings may be less precise than those achieved by an
autopsy conducted shortly after death.
9-4. Unlike the forensic pathologist, who examines fleshed remains, the forensic anthropologist examines
skeletal, semiskeletal, fragmented, badly decomposed, burned, or otherwise unidentifiable human remains.
The objectives of a forensic anthropological examination are the same as those of a medicolegal
examination of a recently deceased individual. However, the skeletonized nature of the remains dictates
that the forensic anthropologist addresses different questions than those posed in a typical medicolegal
autopsy. The forensic anthropologist focuses on—
z Are the remains human?
z Do the remains represent a single individual?
z What is the age, sex, race, and stature of the individual represented by the remains (biological
profile)?
z How long has the individual been dead?
z Are there any skeletal traits or anomalies that are specific to the individual that could aid in a
positive identification?
9-5. In some circumstances, such as partially decomposed remains or mass disasters, the forensic
anthropologist, forensic pathologist, and forensic odonotolgist will work together to retrieve the maximum
amount of information possible from the remains.
9-6. Forensic anthropologists are frequently instrumental in the investigation and management of death
scenes. They apply modified standardized archeological techniques to legal investigations—such as a
buried body or a mass grave—to assist in recovering victims. Forensic anthropologists may also
reconstruct remains, such as a skull severely fragmented by a gunshot wound, to identify trauma to the
body.
27 July 2005 FM 4-20.65 9-1

Chapter 9
BASIC LABORATORY TECHNIQUES

9-7. This model protocol may be used in a variety of situations. Variation in protocol is inevitable or may
even be preferable in some circumstances. Instructions for many of these protocols are in sections that
follow.
9-8. Radiograph skeletal elements before conducting any analysis. Radiographs will detect conditions not
visible to the naked eye, such as healed fractures or the presence of gunshot residue.
9-9. If possible, have a specialist (X-ray technician) obtain bitewing, apical, and/or panoramic dental X-
rays.
9-10. If possible, have a specialist (X-ray technician) X-ray the entire skeleton. Any observed or potential
fractures, developmental anomalies, surgical procedures, or individualizing characteristics should be X-
rayed separately. Frontal sinus (page 9-20) films should be included for identification purposes.
9-11. Prior to analysis, “lay out” the skeletal remains on a table in standard anatomical position to conduct
an inventory and to assure that side, location, and features are consistently noted. Identify the bone; know
its location and proper orientation in the body, and the side of the body it is from. Do not clean the bones.
9-12. Inventory skeletal elements and record on a skeletal chart. Record the condition of the remains (refer
to chapter 4).
9-13. Inventory dental remains and chart on a dental chart. Refer to chapter 5.
9-14. Conduct a preliminary identification of the remains. Determine age, sex, race and stature. Record the
reasons for each conclusion. Photograph all evidence supporting each conclusion. (Refer to following
sections.)
9-15. Examine remains for individualizing characteristics. (Refer to section 9-8.) Record the conditions
observed and the reasons for each conclusion. Photograph all evidence supporting each conclusion.
9-16. Examine the remains for evidence of antemortem and perimortem injuries and postmortem
alterations. If possible, assign each area of trauma to one of these three categories. (Refer to chapter 3.)
Record the reasons for each conclusion. Photograph all evidence supporting each conclusion.
9-17. Photograph the entire skeleton in one frame. Photograph any observed or potential fractures,
developmental anomalies, individualizing characteristics, and prior surgical procedures. Photographs
should contain an identification number and a scale.
ESTIMATION OF SKELETAL AGE

9-18. Assessment of age at death, based on skeletal elements, is an essential part of developing a biological
profile of the individual represented by the remains. Growth-related (developmental) age changes in the
human skeleton occur until the individual reaches approximately 25 years of age (adulthood, skeletally).
During the developmental phase of human growth, age assessment from skeletal remains is more accurate
and straight forward and the assigned age range is typically narrow. After growth and development ceases,
age determination becomes more difficult and the assigned age range is typically broad. After adulthood,
age-related changes to the skeletal system continue in the form of degenerative changes. Thus, the
estimation of age at death in skeletal remains depends on different biological changes occurring in different
periods of life. Entire books have been written on age estimations from the human skeleton. The following
sections on skeletal aging are not meant to be exhaustive, rather they are intended to acquaint the reader
with the methods used to determine the age of an individual at death. They are meant to serve as a basic
reference to allow the mortuary affairs specialist to understand how preliminary age estimations are
determined in the field or mortuary.
ESTIMATION OF FETAL AGE

9-19. There are circumstances, such as abortion or circumvent or suspicious burials, when the gestational
age and/or viability of a fetus can be an important legal issue. The fetal/gestational age of skeletal remains
9-2 FM 4-20.65 27 July 2005

can be estimated from diaphyseal lengths of the long bones, appearance of ossification centers, and/or
dental development. For purposes of this manual, diaphyseal length of the long bones is the preferred
approach.
9-20. During the fetal period, the stage of development is usually expressed in terms of CRL and/or CHL.
CRL (measured from the top of the head to the rump) is used on fetuses up to approximately 20 weeks of
age. After that CHL (measured from the top of the head to the heel) is used. These measurements are taken
using sonograms of the fetus during the mother’s pregnancy. Numerous studies have produced accepted
correlations of CRL and CHL to fetal age. Since CRL and CHL cannot be measured in skeletal remains,
regression equations have been developed for calculating age at death directly from the diaphyseal lengths
of the femur, tibia, fibula, humerus, radius, and ulna. The diaphyseal lengths of fetal long bones are used as
an indicator of how far along the growth/developmental continuum (of CRL and/or CHL) the fetus has
progressed. The diaphyseal lengths of the long bones are measured with calipers and the measurements are
compared to the results produced by the studies on the correlation of CRL and CHL to estimate gestational
age.
9-21. Centers of ossification form throughout the entire period of skeletal development. The fetal
ossification centers include the skull, vertebral column, ribs, sternum, primary centers of the long bones
(diaphyses), shoulder and pelvic girdles, and the hand and foot phalanges. At birth, the human skeleton
consists of approximately 450 centers of bone growth but only six epiphyseal centers are present. These are
the head of humerus; condyles of the femur (distal) and tibia (proximal); and the talus, calcaneus, and
cuboid (bones of the foot). The presence of these epiphyses in the skeletal remains indicates that the fetus
was viable. The epiphyses are very small, comparable to small pebbles, and do not resemble their adult
form. They may not be recognized as human bone by an untrained observer.
9-22. During the fetal period, the crowns of the deciduous teeth grow and calcify within the maxillae and
mandible. At approximately four to five prenatal months, the central incisors begin to form and calcify.
Growth and formation of the deciduous canines and molars continue in a fairly regular sequence around
the jaws. The second deciduous molar begins formation at about six prenatal months. These are tooth
germs, small buds, which do not resemble their deciduous form.
ESTIMATION OF IMMATURE AGE

9-23. In general, immature skeletal remains are those of individuals from birth through 20 years of age.
This developmental phase of human growth is characterized skeletally by predictive sequences of dental
calcification and eruption, appearance of ossification centers, length of long bone diaphyses, and
epiphyseal union. Age at death of immature remains can be estimated within a narrow range by using a
combination of those methods.
Note. A brief review of bone growth will help to understand the mechanics of aging immature
skeletal remains. During the fetal period, the long bones are initially formed as a cartilaginous
model. Between the second and third fetal month, the cartilaginous model begins to be replaced
by bone (ossification). Ossification occurs first in the central part of the shaft, the primary
center. Ossification continues outward until the shaft, diaphyses, is completely ossified. Before
puberty, the secondary centers, the epiphyses, develop at the proximal and distal ends of the
long bones. They are separated for years from the diaphysis by a zone of cartilage. The plate of
cartilage allows for growth. As the diaphysis grows, it eventually unites with the epiphysis
eliminating the cartilaginous plate (epiphyseal union).
Dental Calcification and Eruption

9-24. Dental calcification and eruption is an accurate and reliable method for estimating age in young
individuals. As a general rule, the dentition of females erupts ahead of the dentition of males. Typically, the
mandibular teeth will erupt before the maxillary teeth (both deciduous and permanent). The general
eruption sequences reported below are for male maxillary dentition.
27 July 2005 FM 4-20.65 9-3

Chapter 9
z At birth, the deciduous teeth have not erupted and root formation has not started. Within the
maxillae and mandible, the crowns of the incisors are virtually complete, the canines are about
half complete, the cusps of the first molars are completed and united, and the cusps of the
second molars are half formed but have not yet united.
z The majority of the deciduous teeth erupt between 6 months and 1 year. The deciduous central
incisors usually erupt between 6 and 8 months. The lateral incisors erupt between 8 and 10
months. The deciduous canines erupt between 16 and 20 months. The first deciduous molars
usually erupt toward the end of the first year, but may erupt between 14 and 18 months. The
second deciduous molars erupt between 20 and 24 months. Between 24 to 36 months, all of the
deciduous teeth are expected to be in use.
z Between the ages of 2 and 6 years, there will be a gradual resorption of the roots of the
deciduous teeth. This resorption is prompted by the continued growth and calcification of the
crowns and roots of the permanent teeth.
z Between the ages of 6 and 12 years, the deciduous teeth will shed and the majority of the
permanent dentition will erupt. The first permanent molar erupts around the sixth year of age.
The central incisors erupt between 6 and 7 years and the lateral incisors erupt between 7 and 8
years of age. The canines erupt between 9 and 10 years. The first premolars erupt between 10
and 12 years of age. The second premolars erupt between 11 and 12 years. The permanent
second molar erupts around 12 years. Eruption of the third molars is variable, with eruption
occurring between 17 and 21 years of age.
Appearance of Ossification Centers

9-25. The appearance of ossification centers occurs from birth through approximately 15 years, with
ossification beginning earlier in females. Most centers of ossification appear between birth and 5 years.
The ages of ossification are reported as central tendencies, as there is much variation between individuals.
For example—
z At 2 months, ossification centers for some hand bones appear.
z At 3 months, the distal tibia appears.
z At 7 months, the distal radius appears.
z Between 11 and 26 months, various ossification centers for the hands and feet appear.
z At 3 years, the patella appears.
z At 4 years, the proximal radius appears.
z At 5 years, the distal ulna appears.
9-26. Some ossification centers that appear after 5 years of age include—
z The medial clavicle between 14 and 15 years.
z The proximal ulna between 8 and 10 years.
z The iliac crest between 11 and 14 years.
z The ischial tuberosity between 11 and 15 years.
z The lesser trochanter of the femur between 13 and 16 years.
Epiphyseal Union
9-27. Epiphyseal union of skeletal elements occurs at predictable rates. Females are, on average, two years
in advance of males in epiphyseal union. Epiphyseal union is viewed as a process; it does not occur all at
once. In fact, a range of four years can be seen between the onset of fusion in early-maturing individuals
and completion of fusion in late-maturing individuals. Table 9-1 is provided for basic guidance only. It
incorporates findings from a variety of age-related studies and age ranges were ‘crunched’ to provide a
general overview. The table should be used only as a preliminary indicator of age.
9-4 FM 4-20.65 27 July 2005

Table 9-1. Estimation of immature remains from epiphyseal union

12- 14- 15- 20-
Skeletal Element 0-2 1-3 2-4 3-7 4-6 5-8 17 18 21 25
yrs yrs yrs yrs yrs yrs yrs yrs yrs yrs
Mandibular symphysis X
Anterior and occipital fontanelles X
(closed)
Squamous and lateral parts of X
the occipital bone
Vertebral arches X
Metopic suture X
Dens and centra of axis X
Cervical, thoracic, lumbar, and X
sacral vertebral arches to centra
Lateral and basilar parts of the X
occipitial
Atlas X
Ischiopubic rami X
Female: proximal and distal tibia X
and fibula; head of femur;
acteabulum; medial epicondyle
of humerus; proximal humerus;
greater trochanter of femur;
distal femur
Capitulum, trochlea, and lateral X
condyle of humerus to each
other
Male: medial epicondyle of X
humerus; head of femur;
acetabulum; distal tibia and
fibula
Coracoid process of scapula, X
proximal and distal radius and
ulna
Male: distal femur; proximal X
humerus; proximal tibis and
fibula; greater trochanter of
femur
Heads of ribs, thoracic and X
lumbar epiphyseal rings to body,
iliac creat
Medial epiphyses of clavicle, X
medial border of scapula, ischial
epiphysis
27 July 2005 FM 4-20.65 9-5

Chapter 9
Lengths of Long Bone Diaphyses

9-28. As in fetal remains, the lengths of long bone diaphyses are used to estimate immature age. The
diaphyses of the long bones are measured and the measurements are compared to growth rate charts
derived from a series of known age individuals to arrive at an age range.
ESTIMATION OF ADULT AGE

9-29. Estimation of adult age at death is more difficult than estimations of age at death for fetal and
immature remains. Forensic anthropologists can no longer rely on the relatively regular skeletal and dental
changes associated with growth and development. The techniques used in aging adults are based on
observed gross morphological (and, to a lesser extent, microscopic) changes in bone. These are basically
degenerative changes that are more variable and less precise than those associated with immature remains.
Because age-related changes in the adult skeleton are less obvious than those of the developmental years,
careful attention to bone morphology is a must. When possible, it is best to use as many skeletal age
indicators as available to estimate adult age. An age estimation derived from a variety of indicators will
provide a more accurate age estimation than one derived from a single indicator. The reader must be aware
that age indicators vary between the sexes and populations. Caution must be used when interpreting the
data and estimating adult age.
Pubic Symphysis
9-30. The age related changes in the pubic symphysis have been recognized for years as one of the best
areas from which to determine adult age. Several researchers have conducted studies on determining adult
age from morphological changes in the pubic symphysis—Todd (1920, 1921), McKern and Stewart
(1957), Gilbert and McKern (1973), and several works by Suchey and coworkers. This manual advocates
using the Suchey-Brooks age determination system (Katz and Suchey 1986, Brooks and Suchey 1990, and
Suchey and Katz 1998) as it was developed on a large autopsy sample of modern individuals with well
documented age data. This method uses a single set of descriptions that are applied to both sexes. Although
there are morphological differences between the sexes, the Suchey-Brooks system focuses on key age
changes that were observed in both male and female pubic bones.
9-31. Figure 9-1 shows the location of key traits on the pubic bone in os pubis. The Suchey-Brooks system
uses a pattern approach which is seen in Phases I through VI. The key to recognizing these patterns is as
follows:
z Phase I. “DEEP” ridges and furrows.
z Phase II. Lower and/or upper “end” is forming.
z Phase III. Ventral rampart is in progress of completion (a gap is evident).
z Phase IV. Oval outline is complete (hiatus can occur in upper ventral area).
z Phase V. Symphyseal face is sharply rimmed, some depression.
z Phase VI. Symphyseal face has ongoing depression, rim erodes.
A. “Deep” ridges and grooves, beveled ventral edge (pubic bone is viewed in a horizontal
position).
B. Ventral rampart in process of development (pubic bone is viewed in a horizontal
position).
C. Upper end.
D. Lower end.
E. Oval outline.
F. Hiatus (gap) in the upper ventral aspect.
G. Distinct rim.
H. “Shallow” ridges can persist in old age.
I. Rim erodes.
9-6 FM 4-20.65 27 July 2005

Figure 9-1. Keys to the recognition of patterns in os pubis (Line drawings by Deborah Gray)14
9-32. The following descriptions stress the key features distinguishing the phases in both males and
females. Separate models are necessary so researchers can correctly classify the pubic bones in the
applicable phase (figure 9-2 and figure 9-3). The key to recognizing each phase is in italics.
Figure 9-2. Pubic symphysis morphology for female adult aging15
14
Dr. Judy Suchey.
15
Dr. Judy Suchey.
27 July 2005 FM 4-20.65 9-7

Chapter 9
Figure 9-3. Pubic symphysis morphology for male adult aging16

z Phase 1. The symphyseal face has a billowing surface (ridges and furrows) which usually
extends to include the pubic tubercle. The horizontal ridges are well marked and ventral
beveling may be commencing. Although ossific nodules may occur on the upper extremity, a
key to the recognition of this phase is the lack of delimitation of either extremity (upper or
lower).
z Phase II. The symphyseal face may still show ridge development. The face has commencing
delimitation of lower and/or upper extremities occurring with or without ossific nodules. The
ventral rampart may be in beginning phases as an extension of the bony activity at either or both
extremities.
z Phase III. The symphyseal face shows lower extremity and ventral rampart in process of
completion. There can be a continuation of fusing ossific nodules forming the upper extremity
and along the ventral border. Symphyseal face is smooth or can continue to show distinct ridges.
Dorsal plateau is complete. Absence of lipping of symphyseal dorsal margin; no bony
ligamentous outgrowths.
z Phase IV. Symphyseal face is generally fine grained although remnants of the old ridge and
furrow system may still remain. Usually the oval outline is complete at this stage, but a hiatus
can occur in upper ventral rim. Pubic tubercle is fully separated from the symphyseal face by
definition of upper extremity. The symphyseal face may have a distinct rim. Ventrally, bony
ligamentous outgrowths may occur on inferior portion of pubic bone adjacent to symphyseal
face. If any lipping occurs, it will be slight and located on the dorsal border.
z Phase V. Symphyseal face is completely rimmed with some slight depression of the face itself,
relative to the rim. Moderate lipping is usually found on the dorsal border with more prominent
ligamentous outgrowths on the ventral border. There is little or no rim erosion. Breakdown may
occur on superior ventral border.
z Phase VI. Symphyseal face may show ongoing depression as rim erodes. Ventral ligamentous
attachments are marked. In many individuals, the pubic tubercle appears as a separate bony
knob. The face may be pitted or porous, giving an appearance of disfigurement with the ongoing
process of erratic ossification. Crenulations may occur. The shape of the face is often irregular at
this stage.
16
Dr. Judy Suchey.
9-8 FM 4-20.65 27 July 2005

9-33. Table 9-2 provides the age information for each stage.
Table 9-2. Aging rules related to the

Suchey-Brooks pubic age
determination system
Females Males
Phase Age (years) Age (years)
I 24 or under 23 or under
II 19-24 19-34
III 21-53 21-46
IV 26-70 23-57
V 25-83 27-66
VI 42-87 34-86
Sternal Rib Ends

9-34. Age at death criteria from the sternal rib ends (where the rib end meets the costal cartilage that is
attached to the sternum) are based on the progression of morphological age-related changes to the fourth
rib (Iscan and Loth, 1986). If the fourth rib is not available, the third or fifth rib may be used. Essentially,
the sternal end of the rib in young adults appears billowy. The walls of the margins are thick and the bone
is dense. As age increases, the surface begins to degrade and becomes hollowed out with a cup-like shape.
There is a tendency for the costal cartilage to ossify and for the bone to get thinner. This technique is sex
and population specific, and there are differences between the male and female and black and white
standards. The descriptions of the following phases have been modified for unisex and unirace age
determination. They are, therefore, for use as a preliminary, general identification tool only.
9-35. Phase 0 (16 years and younger). The articular surface is flat or billowy with a regular rim and
rounded edges. The bone is smooth, firm, and very solid (figure 9-4).
Figure 9-4. Phase 0
9-36. Phase 1 (17–19 years). There is a beginning of an amorphous indentation in the articular surface, but
billowing may also still be present. The rim is rounded and regular. In some cases, scallops may start to
appear at the edges. The bone is still firm, smooth, and solid (figure 9-5).
Figure 9-5. Phase 1
9-37. Phase 2 (20–23 years). The pit is now deeper and has assumed a V-shaped appearance formed by the
anterior and posterior walls. The walls are thick and smooth with a scalloped or slightly wavy rim with
rounded edges. The bone is firm and solid.
27 July 2005 FM 4-20.65 9-9

Chapter 9
9-38. Phase 3 (24–28 years). The deepening pit has taken on a narrow to moderate U-shape. Walls are still
fairly thick with rounded edges. Some scalloping may still be present, but the rim is becoming more
irregular. The bone is still quite firm and solid.
9-39. Phase 4 (26–32 years). Pit depth is increasing, but the shape is still a narrow to moderately wide U.
The walls are thinner; however, the edges remain rounded. The rim is more irregular with no uniform
scalloping pattern remaining. There is some decrease in the weight and firmness of the bone; however, the
overall quality of the bone is still good (figure 9-6).
Figure 9-6. Phase 4
9-40. Phase 5 (33–42 years). There is little change in pit depth, but the shape in this phase is predominately
a moderately wide U. Walls show further thinning and the edges are becoming sharp. Irregularity is
increasing in the rim. Scalloping pattern is completely gone and has been replaced with irregular bony
projections. The condition of the bone is fairly good; however, there are some signs of deterioration with
evidence of porosity and loss of density.
9-41. Phase 6 (43–55 years). The pit is noticeably deep with a wide U-shape. The walls are thin with sharp
edges. The rim is irregular and exhibits some rather long bony projections that are frequently more
pronounced at the superior and inferior borders. The bone is noticeably lighter in weight, thinner, and more
porous, especially inside the pit (figure 9-7).
Figure 9-7. Phase 6
9-42. Phase 7 (54–64 years). The pit is deep with a wide to very wide U-shape. The walls are thin and
fragile with sharp, irregular edges and bony projections. The bone is light in weight and brittle with
significant deterioration in quality and obvious porosity.
9-43. Phase 8 (65 years and older). In this phase, the pit is very deep and widely U-shaped. In some cases,
the floor of the pit is absent or filled with bony projections. The walls are extremely thin, fragile, and brittle
with sharp, highly irregular edges and bony projections. The bone is very lightweight, thin, brittle, friable,
and porous (figure 9-8).
Figure 9-8. Phase 8
9-10 FM 4-20.65 27 July 2005

Other Techniques
9-44. The mortuary affairs specialist should be aware that there are numerous additional techniques that
forensic anthropologists employ when determining age at death for skeletal remains. These will not be
covered in depth, as some are subjective and others require specialized equipment.
9-45. Another aging technique that employs visual inspection of morphological changes is based upon the
auricular surface of the os coxae. The auricular surface is the medial surface of the ilium, which articulates
with the sacrum. The technique was developed by Lovejoy and colleagues (1985). The authors note that
auricular surface aging is more difficult to master than pubic symphysis aging techniques.
9-46. The sutures between the various cranial bones fuse progressively as an individual ages. During adult
life, the cranial sutures gradually disappear as adjacent bones unite. In older individuals, they may become
completely obliterated. Suture closure begins endocranially (the interior surface of the skull) and proceeds
ectocranially (the exterior surface of the skull). There is extreme variability in cranial suture closure among
individuals leading to wide age range estimates. Estimation of age at death using cranial suture closure is
not considered reliable. If the skull is the only skeletal element present, then a forensic anthropologist may
venture to place a skull in a decade, such as thirties, forties, fifties, and so forth.
9-47. Other degenerative changes (such as osteoarthritis, ossification of costal and thyroid cartilage, and
the ossification of tendon and ligament insertions) are associated with advanced aging. Generally speaking,
these degenerative changes are unreliable but may be used as an indicator of general age in the absence of
any other indicators. Physical activity, trauma, and some diseases can mimic the appearance of
degenerative changes. In the absence of other age indicators, degenerative changes could be used to
suggest that the individual was more likely at one end of an age range than the other (for example, more
likely at the older end than the younger end of the range).
9-48. There are two microscopic techniques that are used to determine age at death of skeletonized
remains. Microscopic techniques typically provide reliable ages for adults. Tissue samples are taken and
thin sections are prepared for viewing through a microscope on the cellular level. Both techniques,
however, require considerable training and expertise to prepare and interpret the required thin-section
specimens.
9-49. The normal remodeling of bone during adult life is the basis for one of the microscopic techniques
used to determine adult age. Microscopic examinations of thin sections of cortical bone (bone in the long
bone shafts) are used. As the bone must be cut in half at the midshaft in order to obtain the appropriate
cross section, the procedure is destructive to the bone.
9-50. The other microscopic aging technique requires thin sections of a tooth. As with bone, this process is
destructive to the tooth.
9-51. Throughout the life of an individual, degenerative age-related changes occur in the cancellous bone
of the epiphyses. These changes have been documented in the proximal humerus and femur. The basic
premise is that there is a significant correlation between increased age and decreased bone density.
Radiographs are taken of the epiphyses and the observed changes are compared to published standards.
DETERMINATION OF ADULT SEX

9-52. Determination of sex can be made for adult skeletal remains only. As the characteristics do not
manifest themselves until puberty, it is not possible to assign sex to the remains of children and
adolescents. Determining sex from skeletal remains can be made through analysis of the skull and the
postcranial skeleton. There are numerous postcranial elements that are analyzed to determine sex, but only
the major ones will be considered here. Of all the elements, the pelvic bones (figures 9-9, 9-10, and 9-11)
are considered the best elements to determine the sex of adult skeletal remains. They are preferred over the
skull, which is a close second. Using the pelvic bones and the skull together, the forensic anthropologist
can accurately assign sex to skeletal remains with 99% accuracy.
27 July 2005 FM 4-20.65 9-11

Chapter 9
Figure 9-9. Pelvic elements
Figure 9-10. Female pelvis
Figure 9-11. Male pelvis
9-53. Variations in the general shape between the male and female pelvis are the result of the role of the
female pelvis related to gestation and childbirth. In general, the male pelvis (figure 9-12) is rugged with
marked muscle attachment sites. The female pelvis (figure 9-13) is gracile and smooth. Table 9-3 is not an
exhaustive list of traits; it highlights the more obvious sexual differences in the human pelvis. The first
three traits are the most accurate, especially when used together.
9-12 FM 4-20.65 27 July 2005

Figure 9-12. Male pelvic traits
Figure 9-13. Female pelvic trait
27 July 2005 FM 4-20.65 9-13

Chapter 9
Table 9-3. Male and female pelvic traits

Trait Female Male
Ventral arc–a slightly elevated ridge of bone across Present Absent
ventral surface of the pubic bone
Subpubic concavity–observed slightly inferior to the Present Absent
pubic symphysis
Ischiopubic ramus–the region immediately inferior Narrow Broad
to the pubic symphysis
Subpubic angle U-shaped, rounded V-shaped,
sharp angle
Greater sciatic notch Larger, wider, Small, acute
approaches 90 degrees angle
Pelvic Inlet Circular, elliptical Heart-shaped
9-54. Male cranial features are typically more pronounced than female features (figure 9-14). In general
size, the male skull (figure 9-15) is larger than the female skull and the areas of muscle attachment are
more robust (pronounced) and rugged. In addition to the general size and shape of the skull, there are some
individual traits that the observer should focus on in the sex determination of the skull. Table 9-4 is not an
exhaustive list of the traits; it highlights the more obvious sexual differences in the human skull.
Figure 9-14. Basic male and female cranial morphology
9-14 FM 4-20.65 27 July 2005

Figure 9-15. Male cranial morphology
Figure 9-16. Female cranial morphology
Table 9-4. Basic male and female cranial morphology

Trait Male Female
Superorbital ridges Prominent, medium to large Small to medium
Mastoid process Medium to large Small to medium
Occipital area Marked muscle lines and Muscle lines not marked, no
protuberances protuberance
Superorbital margin Rounded Sharp
Symphysis of Square, U-shaped Rounded, V-shaped
mandible
Ramus of mandible Broad, straight Narrower, slanting
Forehead Sloping, less rounded Vertical, full (more rounded)
9-55. In addition to the pelvis, numerous postcranial elements are used to determine sex of skeletal
remains. The clavicle, sternum, scapula, sacrum, calcaneus, humerus, and femur are examples of some
postcranial bones that have been analyzed for sex-specific traits. In general, male skeletal elements are
characterized by larger size and heavier construction. Frequently, the forensic anthropologist will use the
maximum diameter of the head of the humerus and/or femur for determining sex. The maximum diameter
27 July 2005 FM 4-20.65 9-15

Chapter 9
of the head of the humerus and/or the femur (figure 9-17) is measured with sliding calipers and the results
applied to known standards to determine sex (table 9-5).
Figure 9-17. Measuring the maximum diameter of the femur head
Table 9-5. Sex estimation using the humerus and femur

Maximum diameter in mm Females Possible Sex indeterminate Possible Males
Female Male
Head of humerus < 43 -- 44 – 46 -- >47
Head of femur < 42.5 42.5 – 43.5 43.5 – 46.5 46.5 – 47.5
DETERMINATION OF RACE
9-56. Determination of race (ancestry) is an important step in identifying individuals in forensic cases.
There are no “pure races,” and thus racial classification imposes somewhat artificial boundaries. However,
racial classification is a viable category for police agencies.
9-57. Forensic anthropologists are usually obligated to provide legal authorities with a determination of
race for unidentified skeletal remains. To do so, they must accurately assign the skeletal remains to an
ethnic/racial group to which they would most likely have been associated during life. Racial assessment—
in addition to age, sex, and stature assessments—narrows the field of potential missing persons who fit the
biological profile of the skeletal remains.
9-58. Determining race from the skeleton is often difficult and usually depends upon a great deal of
experience in examining skeletal remains. Racial assessment is complicated by several factors. It is a fact
that the people of the world have more in common than they have differences. Racial traits are not very
marked; there is a broad overlap between human races. There are many individuals whose heritage derives
from two or more geographic areas. Thus, for the forensic anthropologist, assessing racial identity from
skeletal remains depends on the identification of degrees of traits that occur with higher frequencies in
certain populations.
9-59. The skull (figure 9-18) is used almost exclusively to assess race. Postcranial elements are also used,
but they are less reliable and will not be addressed here. Racial assessment from the skull can be made
morphologically (observation) and/or metrically (measurement). Traditionally a three-race model has been
used to describe broad cranial characteristics. The races defined are Mongoloid (Asiatics, Native
Americans), Negroid (Africans, African–Americans), and Caucasoid (Europeans, west Asians,
Mediterraneans, and Americans of similar ancestry). Table 9-6 provides an overview of general cranial
morphological differences.
9-16 FM 4-20.65 27 July 2005

Figure 9-18. Cranial landmarks
Table 9-6. Race characteristics of the skull

Trait Mongoloid Negroid Caucasoid
Cranial length Short Long Long
Cranial breadth Broad Narrow Narrow
Cranial height Medium to high Low Medium to high
Facial height High Low Short to high
Facial breadth Very wide Narrow Narrow to wide
Facial profile Flat, rounded Prognathic (projecting Long, narrow
jaws)
Orbits Rounded Rectangular Angular/sloping
Interorbital Narrow Wide Intermediate
breadth
Nasal cavity Narrow to medium Wide Narrow to medium
Nasal sill Blurred Guttered Sharp ridge
Nasal bones Narrow, low-bridged, Broad, flat, short Narrow, high-bridged,
short long
ESTIMATION OF STATURE
9-60. The height of the human body correlates with long bone length. The techniques for estimating stature
from skeletal remains are based on the fact that there is a constant relationship between the size of a given
long bone and the stature of the individual to whom it belonged.
9-61. The length of the leg long bones are more highly correlated with stature than are the lengths of the
arm long bones. The femur is considered the most accurate bone for stature estimation. As a general rule,
the lengths of the arm bones should never be used to estimate stature when leg bones are available. When
all the leg bones are missing or badly fractured, then arm bone measurements are used. The humerus is
considered the most accurate of the arm bones.
9-62. The length of the long bone is measured on an osteometric board that assures an accurate
measurement of overall length (maximum length) in centimeters (see figure 9-19). The measurement is
“plugged” into the correct formulae to calculate an estimation of stature for the individual represented by
the skeletal remains.
27 July 2005 FM 4-20.65 9-17

Chapter 9
Figure 9-19. Measuring the femur on the osteometric board
9-63. The formulae are race and sex specific. Thus, before measuring a bone to estimate stature, the race
and sex of the skeletal remains must first be determined. Numerous studies for establishing living stature
from skeletal remains have been conducted. Because the studies of Trotter and Gleser (1952, 1958) are
considered the most reliable, their formulae and tables are reproduced here.
9-64. Recent research has found a discrepancy with the original Trotter and Gleser methods. This
discrepancy can be avoided by using the femur over the tibia whenever possible. If it is necessary to use
the tibia, then it should be measured without the mallelous.
Table 9-7. Equations to estimate living stature (cm) for individuals between 18
and 30 years with standard errors from the long bones
White Males Black Males
2.89 Hum + 78.10 +/- 4.57 2.88 Hum + 75.48 +/- 4.23
3.79 Rad + 79.42 +/- 4.66 3.32 Rad + 85.43 +/- 4.57
3.76 Ulna + 75.55 +/- 4.72 3.20 Ulna + 82.77 +/- 4.74
2.32 Fem + 65.53+/- 3.94 2.10 Fem + 72.22 +/- 3.91
2.42 Tib + 81.83 +/- 4.00 2.19 Tib + 85.36 +/- 3.96
2.60 Fib + 75.50 +/- 3.86 2.34 Fib + 80.07 +/- 4.02
Mongoloid Males Mexican Males
2.68 Hum + 83.19 +/- 4.25 2.92 Hum + 73.94 +/- 4.24
3.54 Rad + 82.00 +/- 4.60 3.55 Rad + 80.71 +/- 4.04
3.48 Ulna + 77.45 +/- 4.66 3.56 Ulna + 74.56 +/- 4.05
2.15 Fem + 72.57 +/- 3.80 2.44 Fem + 58.67 +/- 2.99
2.39 Tib + 81.45 +/- 3.27 2.36 Tib + 80.62 +/- 3.73
2.40 Fib + 80.56 +/- 3.24 2.50 Fib + 75.44 +/- 3.52
White Females Black Females
3.36 Hum + 57.97 +/- 4.45 3.08 Hum + 64.67 +/- 4.25
4.74 Rad + 54.93 +/- 4.24 2.75 Rad + 94.51 +/- 5.05
4.27 Ulna + 57.76 +/- 4.30 3.31 Ulna + 75.38 +/- 4.83
9-18 FM 4-20.65 27 July 2005

Table 9-7. Equations to estimate living stature (cm) for individuals between 18
and 30 years with standard errors from the long bones
2.47 Fem + 54.10 +/- 3.72 2.28 Fem + 59.76 +/- 3.41
2.90 Tib + 61.53 +/- 3.66 2.45 Tib + 72.65 +/- 3.70
2.93 Fib + 59.61 +/- 3.57 2.49 Fib + 70.90 +/- 3.80
Note. To estimate stature of older individuals, subtract 0.06 centimeter (age in years -30).
9-65. For example, estimate the living stature from the femur of a white 20-year-old female, following
these steps:
z Place the femur on the osteometric board. Measure the maximum length by placing one end
against the immovable upright. Slide the moveable upright until it touches the other end. Read
the maximum length. For this example, the maximum length measured 39.50 centimeters.
z Select the appropriate equation. The equation for the femur of white females is 2.47 Fem +
54.10 +/- 3.72.
z “Plug in” the maximum length of the femur, (39.5 centimeters) into the equation: 2.47 x 39.50 +
54.10 +/- 3.72.
z Perform the math. 97.56 cm + 54.10 = 151.66 cm (59.71 inches).
151.66 cm +/- 3.72
151.66 + 3.72 = 155.38 cm (61.17 inches
151.66 – 3.72 = 147.94 cm (58.24 inches)
9-66. Thus, the estimated living stature of the individual represented by the femur is between 147.94
centimeters and 155.38 centimeters, where 151.66 centimeters is the mean, 147.94 centimeters represents
the low range, and 155.38 centimeters represents the high range of the estimate.
Note. To convert centimeters (stature estimate) into inches, divide the number in centimeters by
2.54 (2.54 inches = 1 centimeter). Thus, 147.94 centimeters equal 58.24 inches, 151.66
centimeters equal 59.71 inches, and 155.38 centimeters equal 61.17 inches.
INDIVIDUALIZATION
9-67. After age, sex, race, and stature have been determined from the remains, attention is directed to any
individualizing characteristics that may exist. The forensic anthropologist will look for a variety of
distinguishing features that will provide a personal identification and confirm a positive identification.
Comparing postmortem radiographs to antemortem radiographs and/or the visual observation of distinct
anomalies, pathologies, and surgical interventions can document individualizing characteristics.
Note. Comparing postmortem radiographs to antemortem radiographs is an excellent means of

providing a positive identification for skeletal remains. If the postmortem radiographs of the
skeletal remains are identical to radiographs of a possible victim taken during life, a positive
identification can be established.
Note. If there is evidence on the skeletal remains for antemortem trauma, injury, or pathology,
the element displaying these characteristics will be X-rayed. All of these conditions will confer
unique markers upon the skeleton. If medical intervention was sought, then antemortem X-rays
should exist for comparison to postmortem X-rays.
27 July 2005 FM 4-20.65 9-19

Chapter 9
9-68. Many parts of the human skeleton demonstrate anatomical developmental variability that is
applicable to the identification process.
9-69. Foremost of these is the frontal sinuses, which are different in every person (even identical twins).
The frontal sinuses develop (increase in size) until about 20 years of age when they become “fixed.”
Radiographs of the skull are commonly taken for the diagnosis of head injuries, orthodontic purposes, and
sinus problems. Frontal sinus patterns may be also observable on some dental radiographs. Military
personnel frequently have skull radiographs on record for identification purposes. These films show the
unique features of the sinuses, which can be compared to the same features on postmortem radiographs.
9-70. General patterns in bone outline, bone density, cancellous bone, and bony projections or nodules are
internal bone structures that are unique to an individual. Radiographs will reveal the details of these
structures and patterns. Virtually any bone, for which an antemortem radiograph exists, can be X-rayed
postmortem for comparison of such individualizing characteristics.
9-71. Frequently surgical implant devices, such as pins, screws, plates, bolts, nails, pacemakers, and
artificial joints are recovered with human remains. Visual observation of these devices may serve to
provide a positive identification. Medical implant devices will usually have a distinctive appearance on X-
rays. But many are also visually distinctive and traceable. Many surgical implant devices are stamped with
a manufacturer’s trademark, serial number, and/or lot number. The manufacturer traces the device by these
identifying markings to their distributor, physicians involved, and finally the patient. Thus, the
identification labels on the devices provide a tracking system that may allow for the identification of the
remains.
VIDEO SUPERIMPOSITION AND FACIAL RECONSTRUCTION

9-72. Video superimposition and facial reconstruction are used as an aid in identifying skeletal remains.
These methods may be employed when skeletal analysis—coupled with other evidence—suggests that
remains are likely to be a certain individual but dental and medical records are not available. They are
generally not considered positive methods of identification. Rather they are typically used to support a
presumptive identification. While there have been some instances when these methods have been accepted
in court as legal identification, they have traditionally been used as corroborating evidence.
9-73. Video superimposition is used in situations in which an investigation has suggested that a set of
remains is likely to relate to a particular missing person. Video superimposition works by superimposing
an antemortem photograph of a BTB individual over the skull of the remains in question. It is an attempt to
supply a face to a skull.
9-74. Typical video superimposition employs two television cameras, an electronic mixing device, and a
viewing screen to overlay an image of a photographed human face over an image of the skull. The skull is
placed under one television camera and the photograph under the other. This allows the skull and the
photograph to be compared on the viewing screen. The mixing device allows for a variety of views (fade
in, fade out, swipe right, swipe left, swipe up, and swipe down) of the skull and photograph for direct bone
to photograph comparison.
9-75. Computer-assisted video superimposition uses digitization and storage in the computer of images of
the photograph and the skull. The skull is aligned using important anatomical landmarks found in the
photograph. The digitized images are superimposed and the software allows for any mixing of bony and
photographic images, including removal of soft tissue to view the skull structure below.
9-76. Successful superimposition depends on the quality of the submitted photographs, proper articulation
of the cranium and mandible, and proper orientation of the cranium and mandible. Even a slight
misalignment of the bones prevents a successful match. A comparison is most successful when the
antemortem photograph shows teeth.
9-77. A three-dimensional reconstruction of the facial features from the skull is frequently used when all
other means of identification have failed. The three-dimensional facial reconstruction technique produces a
clay image directly onto an unidentified skull in an attempt to reproduce the likeness of the living
individual. The purpose is to promote recognition of the person to whom the skull belonged.
9-20 FM 4-20.65 27 July 2005

9-78. Numerous studies have provided data on average soft tissue thickness over 21 anatomical sites of the
skull and jaws. These studies have determined proper tissue depth based on race, sex, and age. The skull is
positioned on a workable stand. Wooden dowels, cut and marked with the appropriate tissue depths, are
glued onto the skull. Modeling clay is then systematically applied to the skull following the skull’s
contours with attention to the applied tissue markers. The reconstruction process is a balance between
scientific data and artistic skills to create a likeness of the face as it may have looked in life. Various
measurements are made to determine the shape of the eyes, nose, and mouth. However, the exact shape of
these features cannot be accurately predicted and some artistic license is taken.
9-79. Advances in graphical computing have lead to the development of computer systems for three-
dimensional facial reconstruction. They use the traditional tissue depth data for coordinates and high-
resolution images to transform laser-scanned, three-dimensional skull images into faces. Having the images
available in a computer facilitates the final comparison of the reproduction with the underlying skull to
make the reproduction as accurate as possible.
27 July 2005 FM 4-20.65 9-21

Appendix A
Preparation of DD Form 890

A-1. DD Form 890, Record of Identification Processing – Effects and Physical Data (figure A-1) is used
to record identifying media in the field or mortuary. Exactness of entries during processing operations is
essential to the final positive identification of remains. All blocks must be completed. When the
information cannot be provided, enter none, none found, or NA (not applicable).
A-2. Start in the top, right block and complete DD Form 890 as follows:
z DATE Block—Enter the date the form is completed.
z NAME Block—Enter the name of the decedent in the order indicated. If unknown, enter
Unknown, Unk., or Unknown X-number.
z GRADE and SERVICE NUMBER/SOCIAL SECURITY NUMBER Block—Make entries
as directed. If unknown, enter Unknown or Unk.
z CIL CASE NUMBER Block—Enter CIL case number, if applicable. If not applicable, enter
NA.
z NAME OF CEMETERY, EVACUATION NUMBER OR SEARCH AND RECOVERY
NUMBER Block—Make entries as directed.
z PLOT, ROW, GRAVE Blocks—Unless it is a cemetery, enter NA.
z RECEIVED FROM Block—Indicate if decedent was obtained through evacuation or search
and recovery. If decedent was received from a cemetery, enter NA.
z IMPRINT OF IDENTIFICATION TAG Block—Enter imprint of the ID tag. If the ID tag is
missing, enter missing. If the tag is too mutilated to imprint, enter mutilated followed by any
legible information on the tag.
z OFFICIAL IDENTIFICATION FOUND WITH REMAINS Block—Enter all information
qualifying as official identifying media. Some examples are as follows:
ID tags. (If found, indicate where they were found on the remains.)
Official identification card (DD Form 2–Armed Forces Identification Card or its
replacement the CAC)
DD Form 1380 (U.S. Field Medical Card).
Motor vehicle operator’s permit, credit cards, marriage certificate, will, money orders.
Objects bearing name and/or service number or social security number.
z ITEMS OF CLOTHING AND EQUIPMENT FOUND WITH REMAINS Block—Enter the
following to the extent available:
Size and type of clothing, distinctive insignia, and laundry markings.
Any visible markings discovered in footgear, headgear, web belt, and helmet liner, as
detailed in AR 700-84. Do not remove clothing/equipment or turn clothing/equipment
inside out. Record only that information that is readily visible.
Full description of insignia, decorations, medals, and campaign badges.
Complete description of military equipment, including identification numbers. Do not
remove clothing/equipment or turn clothing/equipment inside out. Record only that
information that is readily visible.
Data from decedent’s military records, including name, grade, and service or social security
number, along with other pertinent data.
z YES–NO Blocks—Mark an X in the appropriate block to indicate that a procedure was
performed. Attach any relevant pictures or statements resulting from the procedure.
27 July 2005 FM 4-20.65 A-1

Appendix A
z PHYSICAL DESCRIPTION Blocks—Enter information using data taken from skeletal or

anatomical charts or obtained from direct observation.
z NAME, GRADE, ORGANIZATION, and SIGNATURE Blocks—Enter name, grade, and
unit of the preparer of the form. The preparer signs the form in the signature block.
A-2 FM 4-20.65 27 July 2005

Preparation of DD Form 890
Figure A-1. DD Form 890
27 July 2005 FM 4-20.65 A-3

Appendix B
Preparation of DA Form 4137
B-1. DA Form 4137, Evidence/Property Custody Document (figure B-1 and figure B-2) is initiated when
evidence is collected/acquired. This form is a multipurpose form:
z It is a receipt for acquiring evidence.
z It is a record of the chain of custody of evidence and authority for final disposition.
z It cites the final disposition and/or witnessing of destruction of the evidence.
B-2. Each item of evidence that is acquired must be recorded on a DA Form 4137. Entries should be
typed or printed legibly in ink. When evidence is received from a person, give the last copy to him as a
receipt. When evidence is found, rather than received from a person, give the last copy to the responsible
authority at the scene. The original and the first two copies go to the evidence custodian. This individual
keeps the original and first copy for his records. The second copy is returned to the originator for inclusion
in the case file.
B-3. Start in the top, right block and complete DA Form 4137 as follows:
z ADMINISTRATIVE SECTION Blocks—Enter administrative data as requested. Clearly state
the location, reason, and time/date the evidence was obtained.
z DESCRIPTION OF ARTICLES Block—Do the following:
Describe each item of evidence, accurately and in detail.
Cite the model, serial number, condition, and any unusual marks or scratches.
Enter the quantity of an item that is hard to measure or subject to change, like glass
fragments or crushed tablets, using terms like "Approximately 50," or "Undetermined," or
"Unknown."
z CHAIN OF CUSTODY Blocks—This section provides information about the release and
receipt of evidence. From initial acquisition of evidence to its final disposition, every change in
custody must be recorded in this section.
RELEASED BY Column. The first entry under this column contains the signature, name,
and grade or title of the person from whom the property was taken.
Note. If the person refuses or is unable to sign, enter his name on the form and write "Refused"
or "Unable to sign" in the signature block.
Note. If the evidence was found at the scene or if the owner cannot be determined, write NA in
the signature block.
RECEIVED BY Column. This column contains the signature, name, grade or title of the person
receiving the evidence.
PURPOSE OF CHAIN OF CUSTODY Column. Under this column, the action that is
transpiring in regard to the evidence is entered. For example, the evidence collector could write
“transfer from scene to laboratory.” The individual receiving the evidence at the laboratory
could write “received at laboratory for analysis” or “received by evidence custodian.”
27 July 2005 FM 4-20.65 B-1

Appendix B
Note. If and when any change of custody occurs, it is the responsibility of the person in control
of the evidence at that time to ensure that entries of the changes are made on the original DA
Form 4137 and all appropriate copies. The importance of keeping accurate and complete
custody documents cannot be overemphasized.
z FINAL DISPOSAL ACTION / FINAL DISPOSAL AUTHORITY / WITNESS TO

DESTRUCTION OF EVIDENCE Blocks—Entries are self-explanatory.
B-2 FM 4-20.65 27 July 2005

Preparation of DA Form 4137
Figure B-1. DA Form 4137 (front)
27 July 2005 FM 4-20.65 B-3

Appendix B
Figure B-2. DA Form 4137 (back)
B-4 FM 4-20.65 27 July 2005

Appendix C
Evidence Collection and Packaging Guide
GENERAL
C-1. Package all items of evidence separately. All packaging material must be clean and unused. Most
evidence will be packaged in a primary (inner) and secondary (outer) container. When choosing the proper
container, consider the common sense nature of the evidence, such as size, weight, and composition of the
item. Generally, paper bags are the most useful. Minimize the interior movement of the evidence within the
packaging. Seal the package with evidence tape. The evidence tape should cover the opening of the
container completely. The collector will initial across the seal with a permanent marker. (See figure C-1).
Mark the package with a description of the item of evidence; identification of the collector; and date, time,
and location where collected. Practice safety precautions when collecting evidence. Wear rubber gloves,
shoe covers, gowns, masks, and goggles as appropriate.
Figure C-1. Seal the package with evidence tape
PACKAGING MATERIALS
C-2. Basic packaging materials include the following:
z Paper bags
z Plastic zip lock bags
z Cardboard boxes
z Firearm boxes
z Knife boxes
z Pill boxes
z Envelopes of various sizes
z Clean paper/note pad
z Glass jars
27 July 2005 FM 4-20.65 C-1

Appendix C
z Lined, metal paint cans

z Evidence tape
z Labels and markers
z Sterile swabs and boxes
z Large butcher paper
C-3. Specialized materials may include—
z Blood collection kits
z Gunshot residue kits
z Rape kits
z Postmortem fingerprint kits
BODY FLUIDS ON ITEMS

C-4. If possible, body fluids should be allowed to air-dry. When collecting, air-drying, or packaging wet
evidence, do not allow fluids or stains to touch another stained or unstained area. Place paper between
layers of the item, such as a shirt, to avoid transfer or alteration of the fluid. When air-drying items stained
with body fluids, place them on or over a piece of clean paper. The paper will collect any debris/evidence
that falls from the material during drying. The paper will be collected and submitted with the item. Plastic
bags should be used for packaging only when there are excessive fluids and the contamination of other
items is a concern. Wet or moist body fluids should never be packaged in plastic for long periods of time as
it promotes bacterial growth and thus evidence contamination. Paper packaging is preferred if saturation is
not a problem.
LIQUID BLOOD
C-5. If the amount of wet blood is small, then it is collected with sterilized cotton swabs, allowed to air-
dry, and the swab is inserted into a swab box. Do not use double-tipped swabs or Q-Tips. If the amount of
wet blood is large, use a sterile pippet or syringe and transfer the blood to a vacutainer test tube.
DRIED BLOOD
C-6. Dampen a sterile cotton swab with one or two drops of distilled water. Carefully swab the
bloodstain. Allow the entire swab to air-dry and then place in a swab box. If the dried blood is on a small
movable object, then collect the entire object.
DRUG EVIDENCE
C-7. Pills and capsules should be packaged in rigid containers to prevent crushing or damaging evidence.
Prescription bottles with intact labels should be submitted in the original container to preserve evidence
with available information. Biological substances, such as marijuana, should be packaged in paper bags or
wrapped in paper.
FIREARMS
C-8. Firearms should never be collected or packaged loaded. Unload firearms after proper documentation.
If the firearm is a revolver, document the cylinder position. If the firearm is a semiautomatic pistol,
document the condition of the slide mechanism, the number of live rounds in the magazine, and the
presence of any chambered rounds. When collecting and packaging a firearm, consider the possibility of
latent fingerprints and trace evidence. Do not stick anything into the barrel. The firearm may be picked up
by textured grips without damaging latent fingerprints. If fingerprints are not a concern, then package the
firearm in a paper bag. If fingerprints are a concern, package in a manner that the firearm does not come
into contact with any surface of the packaging material. A cardboard box manufactured specifically for
firearms should be used. Do not package firearms in plastic. Package live rounds removed from the firearm
in separate containers.
C-2 FM 4-20.65 27 July 2005

PROJECTILES AND SPENT CASINGS

C-9. Collect projectiles and spent casings with either rubber-tipped forceps or gloves. Place the projectile
or casing in a pill box cushioned with tissue or a zip lock bag. Package each projectile and casing
separately. Do not clean or mark or score the projectile or casing. If fingerprints are not a concern, they
may be packaged in plastic bags. If fingerprints are a concern, immobilize the casing and/or reduce contact
with the packaging material.
TOOLS
C-10. To preserve possible fingerprints, package the tool in a manner that immobilizes the item or reduces
contact with the packaging material. Wrap the working end of the tool to protect microscopic
characteristics and trace evidence.
QUESTIONED DOCUMENTS
C-11. Questioned documents are any documents that bear questioned writing or impressions, including, but
not limited to, checks, demand notes, suicide notes, letters, credit cards, and banks withdrawal forms.
Never mark, fold, staple, pin, or deface the questioned document in any manner. Handle the document
carefully and minimally. Use rubber-tipped tweezers or gloves. A questioned document can be packaged in
most any kind of envelope or plastic bag as long as it fits without folding. Always label the evidence
package before the questioned document is placed inside. If the document is packaged and the package is
marked afterward, then indented writings may be imparted on the questioned document. If the questioned
document is wet, allow it to air-dry. If the document is crumpled, do not straighten the document. Package
it in a rigid container. If a document is torn, do not attempt to piece the document back together.
HAIR AND FIBERS

C-12. Collect hairs and fibers with a tweezers and place in a clean piece of paper using the druggist’s fold
(figure C-2).
z Step 1. Start with a clean sheet of paper.
z Step 2. Crease the paper four times.
z Step 3. Fold the paper lengthwise into thirds—using the two crease lines formed from step 2.
z Step 4. Fold the bottom up.
z Step 5. Place the evidence inside the opening.
z Step 6. Fold the top over and tuck inside the bottom opening.
C-13. Place the paper into a secondary container, such as an envelope or zip lock bag.
27 July 2005 FM 4-20.65 C-3

Appendix C
Figure C-2. Druggist’s fold
GLASS
C-14. Collect glass with consideration to fingerprints when appropriate. Protect each piece from chipping
or breaking in transit. Wrap pieces of glass in paper or tissue paper and place in a rigid container.
PAINT
C-15. Because layers of paint are examined for sequence and number and relative layer thickness, collect
intact paint chips. Do not just scrape the surface, crosscut down to the substrate. Collect an area about the
size of a nickel. Place in a clean vial or pill box or druggist’s fold of clean paper and place the paper in a
paper or plastic envelope or pill box.
SOIL
C-16. Place in a druggist’s fold of clean paper and place the paper into nonairtight containers to allow any
moisture to evaporate.
ACCELERANTS AND FLAMMABLE FLUIDS

C-17. Both liquid and absorbed samples—such as clothing, bedding, or carpet—should be placed in an
airtight container. Lined, unused metal paint cans are preferred. Glass jars can be used as a last resort. Do
not fill cans more than ¾ full.
C-4 FM 4-20.65 27 July 2005

ENTOMOLOGICAL EVIDENCE
C-18. Adult flying insects can be collected with a standard insect net. Crawling insects are collected from
on, in, or under remains with a gloved hand. Both flying and crawling insects should be placed in a
solution of 70 percent ethanol or isopropyl alcohol diluted 1:1 with water. Insects in soil should be scooped
up with some soil and placed into zip lock plastic bags.
27 July 2005 FM 4-20.65 C-5

Glossary
SECTION I – ACRONYMS AND ABBREVIATIONS
ABMDI American Board of Medicolegal Death Investigators

AFDIL Armed Forces DNA Identification Laboratory
AFIP Armed Forces Institute of Pathology
AFMES Armed Forces Medical Examiner System
AIDS acquired immune deficiency syndrome
BIS-GMA bisphenol-A-glycidyl methacrylate
BTB believed-to-be
CAC common access card
CAPMI computer assisted postmortem identification
CAPMI4 computer assisted postmortem identification version 4
CHL crown-heel length
CID Criminal Investigation Division
CIL Criminal Identification Laboratory
cm centimeter
CMAOC United States Army Casualty and Memorial Affairs Operations
Center
CO carbon monoxide
CONUS continental United States
CRL crown-rump length
DNA deoxyribonucleic acid
DOS direct operating system
FBI Federal Bureau of Investigation
Fem femur
Fib fibula
FM field manual
G-4 Deputy Chief of Staff of Logistics
Hum humerus
IDPF individual deceased personnel file
MDI medicolegal death investigation
ml milliliter
mm millimeter
MOPP mission oriented protective posture
MOS military occupational specialty
mtDNA mitochondrial DNA
NA not applicable
OCONUS outside the continental United States
27 July 2005 FM 4-20.65 Glossary-1

Glossary
PCR polymerase chain reaction

PH potential (of) hydrogen
PMI postmortem interval
Rad radius
S symphysis
STP Saf-T-Pak
Tib tibia
U.S. United States
unk unknown
SECTION II – TERMS
alveolar process
The ridge of bone in the maxilla and mandible that contains the alveoli.
alveolus (singular), alveoli (plural)
A single tooth socket, the cavity in which the root of a tooth is held in the alveolar process.
anatomical position
All descriptions of the human body are based on the assumption that the person is standing erect with
the hands at the sides and the face, feet, and palms directed forward. The long bones are not crossed.
The various parts of the body are then described in relation to imaginary planes. Understanding these
planes will facilitate learning terms related to the position of structures relative to each other.
anatomist
An individual who specializes or is skilled in anatomy.
anatomy
The study of the structure of the body and the relationship of its parts to each other. The term
“anatomy” has a Greek origin that means "to cut up" or "to dissect."
anterior (or ventral)
Toward the front of the body. Reference point is the coronal plane.
apex
The terminal or pointed end of the tooth root.
appendicular skeleton
Includes the bones of the arms, legs, shoulder girdle, and pelvic girdle.
articulate (verb)
To unite by one or more joints.
articulation (noun)
The area where two or more bones or skeletal parts come in contact with one another, such as joints
and sutures.
axial skeleton
Includes the bones of the head, vertebrae, ribs, and sternum.
bifid
Divided into two parts, such as a bifid spinous process or a bifid tooth root.
Glossary-2 FM 4-20.65 27 July 2005

Glossary
boss
A rounded eminence, usually used in reference to the shape of the frontal or parietal bones of the
skull.
calvarium
The cranium without the face.
cementum
The bony tissue that covers the root of a tooth.
condyle
A rounded projection for articulation with another bone.
coronal (or frontal)
Anatomical plane that divides the body into anterior (front) and posterior (rear) halves. The coronal
plane is placed at right angles to the sagittal plane.
cranium
The skull minus the mandible.
crest
A narrow, usually prominent ridge of bone.
crown
That part of the tooth covered by enamel (anatomical). It is the portion of the tooth that is visible in the
mouth (clinical).
cusp
A conical or cone-shaped elevation on the occlusal surface of the premolars and molars and on the
incisal edge of the canines.
deciduous dentition
The primary (baby) teeth. They are the first to form, erupt, and function. There are 20 deciduous teeth.
They are shed and replaced by the permanent dentition.
degenerative changes
Changes which occur in the human skeleton after the skeleton has finished growth and development.
These changes are basically ones of erosion and general deterioration and ossification of otherwise
soft tissue.
dentin (or dentine)
The hard tissue that forms the main body of the tooth. It surrounds the pulp cavity and is covered by
enamel in the anatomical crown. Wear of the occlusal surface of a tooth may expose dentin.
dentition All the teeth considered collectively in place in the maxilla and mandible.
diaphysis
The long straight section (shaft) of a long bone.
distal
Farthest from the axial skeleton or further away from the origin of a structure. A term usually used for
the limb bones. For example, the distal humerus articulates with the (proximal) ulna and radius. The
distal tooth surface is the surface farthest from the midline.
dorsal
The back side of the body, also known as posterior. The term “dorsal” also refers to the top of the foot
and the back of the hand.
ectocranial
The outer surface of the cranial vault.

Glossary
edentulous
Without teeth. It may refer to the loss of all the maxillary and/or mandibular teeth. The alveolar
process shows no sockets for the teeth as bone growth has totally “filled in” the sockets.
eminence
A bony projection that is usually not as prominent as a process.
enamel
The white mineralized tissue that covers the dentin of the anatomical crown of the tooth.
endocranial
The inner surface of the cranial vault.
epiphyseal closure
The fusion of the epiphysis with the diaphysis that occurs during adolescence.
epiphysis (singular); epiphyses (plural)
The end of a long bone that is originally separated from the diaphysis by a layer of cartilage but that
later becomes united to the diaphysis through ossification.
facial (or labial)
The surface toward the lips (outside) in the anterior dentition and toward the cheeks in the posterior
dentition. The terms “facial” and “labial” are used interchangeably. However, the term “facial” will be
used in this manual for consistency in charting dental remains.
fontanelle
A membranous space between the cranial bones (the “soft spot”) in fetal life and infancy. There are
numerous fontanelles, including the anterior, posterior, mastoid, and sagittal fontanelle.
foramen
A round or oval hole, an opening. The foramen magnum is the large hole in the base of the skull
through which the spinal cord passes.
forensic anthropologist
A specialist in the human skeletal system. He has advanced training in human anatomy and all aspects
of the human skeleton. He combines his knowledge of human anatomy and the human skeleton to
evaluate skeletonized or partially skeletonized remains in a legal context.
fuse/fusion (or union)
When the epiphyses of the bones unite (ossify) to their respective elements. This term is used
interchangeably with the term epiphyseal closure.
gross anatomy
Deals with the naked-eye appearance of tissues and organs.
head
The large, rounded articular end of a long bone, such as in the head of the humerus and the head of the
femur.
horizontal (or transverse)
Anatomical plane that divides the body into superior (upper) and inferior (lower) parts. Unlike the
coronal and sagittal planes, this plane can pass through the body at any height.
incisal
The biting edge of the anterior teeth.
inferior.
Closer to the feet. Reference point is the horizontal plane.
lateral
Away from the midline. Reference point is the sagittal plane.

Glossary
lingual
The surface of the tooth toward the tongue (inside).
medial
Toward the midline. Reference point is the sagittal plane.
mesial
The surface of the tooth nearest the midline of the dental arch.
morphology
The branch of biology which deals with structure and form. In osteology it refers to the shape and size
of a bone or its general appearance.
neck
The constricted portion of bone between the head of a long bone and the shaft or the constricted part
of the tooth at the junction of the crown and root.
occlusal surface
The biting edge of the anterior teeth and the chewing surface of the posterior teeth.
odontologist
A dentist with a specialized interest in identification.
odontology
The study of the development, formation, and abnormalities of the teeth.
ossification
The formation of bone, the conversion of cartilage into bone (mineralization).
osteology
The detailed study and analysis of bones and the skeletal system.
palmar
The palm side of the hand, also known as volar.
permanent dentition
The adult teeth, which are 32 in number.
plantar
The sole of the foot.
posterior (or dorsal)
Toward the back of the body. Reference point is the coronal plane.
process
A bony projection or prominence.
prone
Lying on anterior surface of the body (stomach) with the face down.
proximal
Nearest the axial skeleton or closer to the origin of a structure, near the trunk or head. A term usually
used for the limb bones. For example, the head of the humerus is the proximal end.
pulp
The soft tissue that constitutes the central cavity of the tooth. It includes nerves and blood vessels.
pulp cavity
The entire central cavity of a tooth, which contains the pulp.
root
The part of the tooth that anchors the tooth in the alveolus. It is covered by cementum.

Glossary
sagittal (or median)

Anatomical plane that separates the body into symmetrical right and left halves.
sinus
A cavity within a cranial bone.
skull
The entire bony framework of the head and mandible.
spine
A long, thin, sharp projection.
stature
The height of any animal while standing.
superior
Closer to the head. Reference point is the horizontal plane.
supine
Lying on the back with the face up.
suture
A specially serrated and interlocking joint where the adjacent bones of the skull meet.
symphysis (singular); symphyses (plural)
The line or junction formed by a cartilaginous articulation, the most common being between the two
bones of the pelvis and the two halves of the mandible.
trochanter
A large roughened prominence for the attachment of muscles, specifically one of two processes found
on the femur for the attachment of rotator muscles.
tubercle
A small, roughened, rounded eminence.
tuberosity
A roughened, rounded protuberance, such as those found on the humerus.

References
SOURCES USED
These are the sources quoted or paraphrased in this publication.
ARMY REGULATIONS
AR 638-2, Care and Disposition of Remains and Disposition of Personal Effects,
22 December 2000.
AR 700-84, Issue and Sale of Personal Clothing, 18 November 2004.
DEPARTMENT OF THE ARMY FORMS AND PAMPHLETS

DA Form 2028, Recommended Changes to Publications and Blank Forms.
DA Form 2773, Statement of Identification.
DA Form 4137, Evidence/Property Custody Document.
DA Pamphlet 638-2, Deceased Personnel Care and Disposition of Remains and Disposition
of Personal Effects, 22 December 2000.
DEPARTMENT OF DEFENSE PUBLICATIONS AND FORMS

DD Form 1380, US Field Medical Card.
DD Form 2, Armed Forces of the United States Identification Card.
DD Form 565, Statement of Recognition of Deceased.
DD Form 890, Record of Identification Processing – Effects and Physical Data.
Department of Defense Directive (DODD) 5154.24, Armed Forces Institute of Pathology
(AFIP), 3 October 2001.
OTHER
SF 603, Health Record – Dental.
Section 1471, Title 10-Armed Forces, United States Code (10 USC 1471), Subtitle A, Part II,
Chapter 75, Subchapter 1.
Crime Scene Investigation: A Guide for Law Enforcement, National Institute of Justice (NIJ)
Guide, U.S. Department of Justice, January 2000.
Death Investigation: A Guide for the Scene Investigator, NIJ Guide, U.S. Department of
Justice, November 1999.
Brooks, S. and Suchey, J.M. Skeletal Age Determination Based on the Os Pubis: A
Comparison of the Acsadi-Nemeskeri and Suchey-Brooks Methods. Human
Evolution, Vol. 5, No. 3, pp. 227-238, 1990.
Di Maio, V., Gunshot Wounds Practical Aspects of Firearms, Ballistics, and Forensic
Techniques, Second Edition; Boca Raton, Florida: CRC Press LLC, December 1998.
Di Maio, D.J., and Di Maio, V. Forensic Pathology, Second Edition, Boca Raton, Florida:
CRC Press LLC, June 2001.
Dix, J., and Ernst, M.F. Handbook for Death Scene Investigators, Boca Raton, Florida: CRC
Press LLC, March 1999.
Fisher, B.A., Techniques of Crime Scene Investigation, Sixth Edition, Boca Raton, Florida:
CRC Press LLC, 2002.
27 July 2005 FM 4-20.65 References-1

References
Fuller, J.L., and Denehy, G.E., et al. Concise Dental Anatomy and Morphology, Iowa City,
IA, University of Iowa College of Dentistry, 2001.
Gray, H., T.P. Pick, et al. Anatomy, Descriptive and Surgical, New York, Bounty Books:
Distributed by Crown, 1987.
Krogman, W.M., and Iscan, M.Y. The Human Skeleton in Forensic Medicine, Second
Edition, Charles C. Thomas Publishers, Springfield, Illinois, 1986.
Lee, L.C., Palmbach, T., and Miller, M.T., Henry Lee’s Crime Scene Handbook, Academic
Press, New York, July 2001.
Snell, R. S., Clinical Anatomy for Medical Students, Little, Brown, and Company; Boston,
Massachusetts, 1986.
Trotter, M. and Gleser, G.C., Estimation of Stature from Long Bones of American Whites and
Negroes, American Journal of Physical Anthropology, 19: pp. 213-227, 1952.
Trotter, M. and Gleser, G.C., A Re-Evaluation of Estimation Based on Measurements of
Stature Taken During Life and of Long Bones After Death, American Journal of
Physical Anthropology, 16: pp. 79-123, 1958.
DOCUMENTS NEEDED
These documents must be available to the intended users of this publication.
JOINT PUBLICATION
JP 4-06, Joint Tactics, Techniques and Procedures for Mortuary Affairs in Joint Operations,
28 August 1996.
FIELD MANUALS
FM 10-64, Mortuary Affairs Operations, 16 February 1999 (will be revised as FM 4-20.64).
FM 3-19.13 (FM 19-20), Law Enforcement Investigations, 10 January 2005.
READINGS RECOMMENDED
These readings contain relevant supplemental information.
NONMILITARY PUBLICATIONS
Bass, W.M. Human Osteology: A Laboratory and Field Manual, Fourth Edition (Special
Publication No. 2 of the Missouri Archaeological Society), Columbia, MO,
November 1995.
Clark, S.C., Ernst, M.F., Haglund, W.D., and Jentzen, J.M., Medicolegal Death Investigation,
A Systematic Training Program for the Professional Death Investigator,
Occupational Research and Assessment Inc., Big Rapids, Michigan, 1996.
Friedman, R.B., Cornwell, K.A., and Lorton, L., Dental Characteristics of a Large Military
Population Useful for Identification, American Journal of Forensic Sciences, 34(6):
pp.1357-1364, 1989. (ISSN 0022-1198, published by ASTM International.)
Gilbert, B.M., and McKern T.W., A Method of Aging the Female Os Pubis, American Journal
of Physical Anthropology, 38: pp. 31–38, 1973.
Katz, D., and Suchey, J.M., Age Determination of the Male Os Pubis, American Journal of
Lovejoy, C.O., Meindl, R.S., Pryzbeck, T.R., and Mensforth, R.P. Chronological
Metamorphosis of the Auricular Surface of the Ilium: A New Method for the
References-2 FM 4-20.65 27 July 2005

References
Determination of Adult Skeletal Age at Death. American Journal of Physical

Anthropology 68: pp. 15-28, 1985.
McKern T.W., and Stewart T.D. Skeletal Age Changes in Young American Males.
Headquarters Quartermaster Research and Development Command, Technical Report
EP- 45, Quartermaster Research and Development Center, Environmental Protection
Research Division, Natick MA, 1957.
Scheuer, L. and Black, S. Developmental Juvenile Osteology, Academic Press, London, 2000.
Scheuer, L. and Black, S. Developmental Juvenile Osteology, Academic Press, London, 2000.
(ISBN 0-12-624000-0)
Suchey, J. M., and Katz, D., Skeletal Age Standards Derived from an Extensive Multiracial
Sample of Modern Americans. Paper presented at the Annual Meeting of the
American Association of Physical Anthropologists, Albuguerque, New Mexico,
1986.
Suchey, J. M., and Katz, D., Applications of Pubic Age Determination in a Forensic Setting.
In Forensic Osteology Advances in the Identification of Human Remains, Second
Edition, Reichs, K ed., pp. 204-214, 1998.
Todd, T.W., Age Changes in the Pubic Bone. I: The male white pubis. American Journal of
Todd, T.W., Age Changes in the Pubic Bone. II: The Pubis of the Male Negro-White Hybrid,
III: The Pubis of the White Female. IV: The Pubis of the Female Negro-White
Hybrid. American Journal of Physical Anthropology, 4: pp. 1-70, 1921.
Wecht, C.H., Use of Forensic Pathology in Defending Criminal Cases. In Forensic Sciences
Volume 1, Mathew Bender and Co., Inc., Albany, New York, pp. 25-3 through 25-
104, 1988. (Library of Congress Catalog #81-69427, Times Mirror Books.)
Wecht, C.H., Autopsy Law and Procedures in Forensic Sciences, Volume 1, Mathew Bender
and Co., Inc., Albany, New York, pp. 26-3 through 26-86, 1988. (Library of
Congress Catalog #81-69427.)
27 July 2005 FM 4-20.65 References-3

Index
carbon monoxide, 3-22 document and evaluate the

A chemical, 3-21 death scene, 6-4
adult age cyanide, 3-22 document the body, 6-10
estimating, 9-6 strangulation, 3-21 establish and record
other techniques, 9-11 suffocation, 3-21 decedent's profile, 6-14
pubic symphysis, 9-6 axial skeleton, 2-3 maintain ethical and legal
sternal rib ends, 9-9 responsibilities, 6-16
adult human skeleton, 4-4 B death scene
skull, 4-5 blunt force and forensic
adult postcranial skeleton, 4-10 categories, 3-6 anthropologists, 9-1
cervical vertebrae, 4-11 injury, 3-5 body assessment, 6-10
clavicle, 4-17 injury to the skull, 3-11 debriefing, 6-13
femur, 4-26 blunt force categories evidence on the body, 6-12
fibula, 4-29 abrasions, 3-6 local law enforcement at,
foot, 4-31 contusion, 3-7 6-1
hand, 4-22 fracture, 3-9 medicolegal death
humerus, 4-18 laceration, 3-8 investigator at, 6-1
hyoid bone, 4-10 photographic
burns, 3-1 documentation, 6-10
lumbar vertebrae, 4-14 first degree, 3-2
patella, 4-27 photographs, 6-4
fourth degree, 3-3 postmortem changes, 6-11
pelvic girdle, 4-23 pugilistic posture, 3-4
radius, 4-19 security of the remains,
rules of nines, 3-4 6-13
scapula, 4-16 second degree, 3-2
sternum, 4-15 sketches of, 6-5
third degree, 3-3
thoracic vertebrae, 4-13 death scene investigator, 6-12
tibia, 4-28 C documentation of the death
ulna, 4-21 cause and manner of death, scene, 6-5
vertebral column, 4-11 6-1, 6-11, 6-12, 6-14, 7-1, location of injury or illness,
adult sex 7-3, 7-8 6-7
determination of, 9-11 physical evidence and
chain of custody, 1-4 personal property, 6-8
age photographs, 1-4 proficiency of, 6-8
estimation of adult, 9-6 charts witnesses at the death
estimation of fetal, 9-2 anatomical, 1-4 scene, 6-9
estimation of immature, 9-3 dental, 1-4 death scene sketch
alveolar process, 4-1 fingerprint, 1-4 exploded view, 6-6
American Board of Forensic footprint, 1-5 floor plan, 6-5
Anthropology, 9-1 skeletal, 1-4 triangulation method, 6-6
anatomical planes, 2-2 chemical asphyxia deciduous dentition
carbon monoxide, 3-22 types, 5-7
anatomical position, 2-1 cyanide, 3-22
anatomical terminology, 2-1 dental anomalies, 5-16, 5-17
coroner system, 6-1 abrasions, 5-16
anatomy cranial features dental fluorosis, 5-16
definition of, 2-1 male and female, 9-14 diastema, 5-16
anterior teeth surface enamel hypoplasia, 5-16
distal, 5-3 D enamel pearls, 5-16
facial, 5-3 DA Form 4137, 1-4, 6-4, B-1 erosion, 5-16
lingual, 5-3 DA Pam 638-2 fusion, 5-16
mesial, 5-3 disposing of personal macrodontia, 5-17
appendicular skeleton, 2-3, 4-1 effects, 1-3 microdontia, 5-17
AR 638-2 DD Form 890, 1-2, 1-3, 1-4, migration, 5-17
disposing of personal 1-5, 7-2, A-1 rotation, 5-17
effects, 1-3 chain of custody, 1-4 supernumerary, 5-17
tooth fracture, 5-16
articulation, 4-1 death investigator
dental calcification and
asphyxia, 3-21 eruption, 9-3
27 July 2005 FM 4-20.65 Index-1

Index
dental cavities, 5-14 Fingerprint Identification Kit, cusp, 5-1

dental chart, 1-3, 8-1, 8-4, 9-2 8-12 deciduous dentition, 5-1
contents, 8-1 hands clenched, 8-16 dentin, 5-2
radiographs, 8-2 maceration, 8-24 dentition, 5-2
newly dead, 8-12 edentulous, 5-2
dental conclusions photographic techniques, enamel, 5-2
exclusion, 8-5 8-25 forensic odontologist, 5-2
insufficient evidence, 8-5 powder and label method, neck, 5-2
positive identification, 8-5 8-11 odontology, 5-2
possible identification, 8-5 wrinkled fingertips, 8-19 permanent dentition, 5-2
dental identification foot pulp, 5-2
possible conclusions, 8-5 pulp cavity, 5-2
metatarsals, 4-32
dental restorations, 5-14 phalanges, 4-32 root, 5-2
direct restorative dental tarsal, 4-32 standardized terminology,
materials, 5-15 5-1
footprinting, 8-26
indirect restorative dental human osteology, 9-1
materials, 5-15 footprints
for pilots, 1-5 human skeletal system
permanent restorative standardized terminology,
materials, 5-15 forensic anthropologist, 4-3, 4-1
temporary restorative 6-15, 9-1, 9-6, 9-11, 9-15,
materials, 5-14 9-19 I
DNA focus of, 9-1 identification
definition of, 8-26 forensic odontologist, 8-4 positive, 6-16
harvesting, 8-28 possible conclusions of, 8-5 presumptive, 6-15
profiling, 8-27 forensic odontology, 5-2, 8-1, unidentified, 6-15
transporting, 8-29 8-4 identifying human remains, 8-1
uses, 8-27 dental, 8-1
fracture
DNA profiling angulation, 3-10 DNA, 8-26
mitochondrial DNA, 8-28 circular, 3-13 fingerprinting, 8-5
nuclear DNA, 8-27 comminuted, 3-12 identifying remains
drowning, 3-22 compound, 3-9 policies for, 1-1
autopsy, 3-22 compression, 3-11 immature age
rigor mortis, 3-22 crush, 3-9 dental calcification and
definition of, 3-9 eruption, 9-3
E depression, 3-12 epiphyseal union, 9-4
epiphyseal union, 9-4 diastatic, 3-13 estimating, 9-3
evidence direct, 3-9 long bone diaphyses, 9-5
dried blood, C-2 greenstick, 3-9 ossicication centers, 9-4
packaging, 6-9 indirect, 3-10
linear, 3-13 indirect fractures
evidence packaging, C-1 angulation, 3-10
penetrating, 3-10
examination rotational, 3-11 rotational, 3-11
of clothing and equipment, simple, 3-9 tension, 3-10
1-2 stellate, 3-13 injury definition, 3-1
of military equipment, 1-2 tapping, 3-9 interviews
of official identification, 1-2 tension, 3-10 avoid technical terms in,
F 6-10
G
data to collect at, 6-9
fetal and immature skeleton, gunshot wound with witnesses, 6-9
4-32 contact, 3-16
fingerprinting classification distant, 3-18 J
arch pattern, 8-7 entrance and exit, 3-19 John Doe, 6-15
loop pattern, 8-8 intermediate, 3-18
whorl pattern, 8-9 near contact, 3-17 L
fingerprinting procedures, 8-11 laboratory techniques
H
advanced decomposition, 8- skeletal remains, 9-2
20 human dentition, 5-1
Locard’s Principle of Exchange,
desiccation, 8-22 alveolar process, 5-1
6-8
early decomposition, 8-19 apex, 5-1
cementum, 5-1 long bone diaphyses, 9-5
crown, 5-1
Index-2 27 July 2005 FM 4-20.65

Index
M male and female, 9-12 estimating fetal age, 9-2

major internal organs, 2-4 permanent dentition estimating immature age,
appendix, 2-16 mandibular canines and 9-3
brain, 2-4 cuspids, 5-9 skeletal remains
esophagus, 2-12 mandibular molars, 5-12 basic laboratory techniques,
gallbladder, 2-8 maxillary canines and 9-2
heart, 2-7 cuspids, 5-9 determining adult sex, 9-11
kidneys, 2-11 maxillary incisors, 5-7 determining race, 9-16
large intestine, 2-15 maxillary molars, 5-12 estimating skeletal age, 9-2
liver, 2-8 personal effects estimating stature, 9-17
lungs, 2-6 AR 638-2, 1-3 facial reconstruction, 9-20
pancreas, 2-10 DA Pam 638-2, 1-3 individualization, 9-19
small intestine, 2-14 disposing of, 1-3 video superimposition, 9-20
spleen, 2-11 skeleton. See adult human
physical evidence, 6-3, 6-5,
stomach, 2-13 skeleton
6-7, 6-8, 6-10, 6-12, 6-13,
urinary bladder, 2-12
7-1, 7-2 skull
media ethmoid bone, 4-9
postdeath investigation
collective, 1-3 frontal bone, 4-6
decedent's identification,
inconclusive, 1-3 inferior nasal conchae bone,
6-15
single-item, 1-3 4-10
decedent's medical history,
medical examiner system, 6-1 6-14 lacrimal bone, 4-9
medicolegal death investigator, decedent's mental health mandible bone, 4-10
6-1 history, 6-14 maxillae, 4-9
at death scene, 6-2 decedent's social history, nasal bone, 4-9
role of, 6-2 6-14 occipital bone, 4-8
discovery history, 6-14 palatine bone, 4-9
O terminal episode parietal bone, 4-8
odontological and anatomical information, 6-14 sphenoid bone, 4-10
temporal bone, 4-8
terminology, 5-1 posterior teeth surface vomer bone, 4-10
ossification, 4-3 distal, 5-4 zygomatic bone, 4-10
facial, 5-4
ossification centers, 9-4 stature
lingual, 5-4
osteological terminology, 4-1 mesial, 5-4 estimation of, 9-17
leg long bone, 9-17
P prosthetic appliances, 5-15
dental bridge, 5-16 sternal rib ends
packaging evidence, 6-9 phases of, 9-9
dental implants, 5-16
accelerants and flammable
denture, 5-15 supporting documents
fluids, C-4
pugilistic posture, 3-4 most frequently used, 1-5
body fluids, C-2
drugs, C-2 T
entomological evidence,
R
race teeth classification, 5-4
C-5
determination of, 9-16 deciduous dentition, 5-4
firearms, C-2
using the skull for, 9-16 permanent dentition, 5-5
glass, C-4
hair and fibers, C-3 radiograph, 6-15, 6-16, 8-2 terms of direction, 2-3
liquid blood, C-2 bitewing, 8-3 tooth surface, 5-3
paint, C-4 panoramic, 8-3 anterior teeth, 5-3
projectiles and spent periapical, 8-2 posterior, 5-4
casings, C-3 skeletal elements, 9-2
questioned documents, C-3 U
records
soil, C-4 maintaining, 1-2 U.S. Army Human Resources
tools, C-3 Command, 1-1
rules of nines, 3-4
packaging materials, C-1 universal numbering system,
basic, C-1 S 5-6
specialized, C-2 Saf-T-Pak System, 8-29
pelvic girdle
W
scene debriefing, 6-13 wound
coccyx, 4-23
os coxae, 4-23 sharp force injury, 3-13 definition of, 3-1
sacrum, 4-23 skeletal age formula, 3-6
pelvis estimating adult age, 9-6 wounds
27 July 2005 FM 4-20.65 Index-3

Index
chop, 3-15 incised, 3-14 wounds and injuries, 3-1

gunshot, 3-16 stab, 3-14
hesitation marks, 3-15
Index-4 27 July 2005 FM 4-20.65

FM 4-20.65 (FM 10-286)
27 July 2005
By order of the Secretary of the Army:
PETER J. SCHOOMAKER
General, United States Army
Chief of Staff
Official:
SANDRA R. RILEY
Administrative Assistant to the
Secretary of the Army
0518702
DISTRIBUTION:
Active Army, Army National Guard, and U.S. Army Reserve: To be distributed in accordance
with the initial distribution number (IDN) 110890, requirements for FM 4-20.65.
PIN: 082564-000

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Identification of Deceased Personnel

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*This publication supersedes FM 10-286, 30 June 1976.

Chapter 4 HUMAN OSTEOLOGY.......................................................................................4-1

ii FM 4-20.65 27 July 2005

Appendix B PREPARATION OF DA FORM 4137 ................................................................B-1

27 July 2005 FM 4-20.65 iii

iv FM 4-20.65 27 July 2005

Figure 4-16. Typical lumbar vertebra, lateral view ...............................................................4-14

27 July 2005 FM 4-20.65 v

Figure 5-11. Maxillary left first premolar/bicuspid ................................................................ 5-11

vi FM 4-20.65 27 July 2005

Figure 8-27. Eligible donors of mtDNA samples ..................................................................8-28

27 July 2005 FM 4-20.65 vii

Table 9-6. Race characteristics of the skull ......................................................................... 9-17

viii FM 4-20.65 27 July 2005

ix FM 4-20.65 27 July 2005

x FM 4-20.65 27 July 2005

POLICIES FOR THE FORENSIC IDENTIFICATION OF REMAINS

27 July 2005 FM 4-20.65 1-1

EXAMINATING AND RECORDING DATA

INDIVIDUAL CLOTHING AND EQUIPMENT

1-2 FM 4-20.65 27 July 2005

27 July 2005 FM 4-20.65 1-3

1-4 FM 4-20.65 27 July 2005

27 July 2005 FM 4-20.65 1-5

GLOSSARY OF ANATOMICAL TERMINOLOGY

27 July 2005 FM 4-20.65 2-1

Figure 2-1. Anatomical position1

2-2 FM 4-20.65 27 July 2005

Figure 2-2. Anatomical planes2

TERMS OF DIRECTION OR RELATION FOR THE BODY AND THE SKELETON

27 July 2005 FM 4-20.65 2-3

Figure 2-3. Directional terms

MAJOR INTERNAL ORGANS

2-4 FM 4-20.65 27 July 2005

Figure 2-4. The brain, gross, lateral view

Figure 2-5. The brain, gross, superior view

Figure 2-6. Diagram of the lobes of the brain3

27 July 2005 FM 4-20.65 2-5

Figure 2-7. The lungs, gross, lateral view

Figure 2-8. The lungs, gross, medial view

2-6 FM 4-20.65 27 July 2005

Figure 2-9. The heart, diagram of exterior structures4

Figure 2-10. The heart, gross

27 July 2005 FM 4-20.65 2-7

Figure 2-11. The liver, gross, superior view

2-8 FM 4-20.65 27 July 2005

Figure 2-12. The gallbladder, diagram of the exterior surface

Figure 2-13. The gallbladder, gross

27 July 2005 FM 4-20.65 2-9

Figure 2-14. Upper abdominal viscera, gross, anterior view

Figure 2-15. The pancreas, gross

2-10 FM 4-20.65 27 July 2005

Figure 2-16. The spleen, anterior border, gross

27 July 2005 FM 4-20.65 2-11

THE URINARY BLADDER